Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.60 / $61.28 / $191.41	Facility	26	$54.60	$61.28	$191.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.09 / $222.66 / $608.90	Professional		$168.09	$222.66	$608.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.03 / $61.28 / $158.18	Professional	26	$38.03	$61.28	$158.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.06 / $161.38 / $450.72	Professional	TC	$130.06	$161.38	$450.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.25 / $117.25 / $117.25	Professional		$117.25	$117.25	$117.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.76 / $29.03 / $119.67	Professional	26	$27.76	$29.03	$119.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.65 / $173.59 / $274.68	Professional		$142.65	$173.59	$274.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $41.10 / $71.20	Professional	26	$36.22	$41.10	$71.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.42 / $132.49 / $203.47	Professional	TC	$106.42	$132.49	$203.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.89 / $307.58 / $439.38	Professional		$179.89	$307.58	$439.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.76 / $71.81 / $109.36	Professional	26	$41.76	$71.81	$109.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.18 / $227.75 / $338.28	Professional	TC	$138.18	$227.75	$338.28
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $175.15 / $310.61 / $576.96	Professional		$175.15	$310.61	$576.96
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $41.47 / $71.73 / $128.00	Professional	26	$41.47	$71.73	$128.00
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $133.68 / $231.24 / $412.60	Professional	TC	$133.68	$231.24	$412.60
United Facility/Professional Professional Modifier Low / Median / High Price $194.51 / $278.45 / $562.53	Professional		$194.51	$278.45	$562.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.40 / $77.03 / $133.80	Professional	26	$49.40	$77.03	$133.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.68 / $211.12 / $428.73	Professional	TC	$133.68	$211.12	$428.73
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $132.66 / $165.96 / $228.44	Professional		$132.66	$165.96	$228.44
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $30.56 / $42.78 / $62.90	Professional	26	$30.56	$42.78	$62.90
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $90.05 / $111.66 / $170.55	Professional	TC	$90.05	$111.66	$170.55