Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.97 / $243.95 / $243.95	Facility	26	$115.97	$243.95	$243.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $158.63 / $234.55	Professional		$130.08	$158.63	$234.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.61 / $78.73 / $115.74	Professional	26	$71.61	$78.73	$115.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.79 / $80.56 / $121.15	Professional	TC	$54.79	$80.56	$121.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.34 / $75.34 / $75.34	Professional	26	$75.34	$75.34	$75.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.44 / $217.65 / $352.89	Professional		$149.44	$217.65	$352.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.66 / $111.65 / $167.06	Professional	26	$76.66	$111.65	$167.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.78 / $106.00 / $170.87	Professional	TC	$72.78	$106.00	$170.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.30 / $273.20 / $481.04	Professional		$150.30	$273.20	$481.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.43 / $138.55 / $234.87	Professional	26	$91.43	$138.55	$234.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.08 / $143.18 / $246.17	Professional	TC	$54.08	$143.18	$246.17
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $168.12 / $268.82 / $528.04	Professional		$168.12	$268.82	$528.04
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $87.76 / $144.66 / $270.87	Professional	26	$87.76	$144.66	$270.87
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $83.32 / $137.06 / $257.17	Professional	TC	$83.32	$137.06	$257.17
United Facility/Professional Professional Modifier Low / Median / High Price $167.90 / $234.81 / $586.87	Professional		$167.90	$234.81	$586.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.76 / $120.75 / $280.24	Professional	26	$87.76	$120.75	$280.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.47 / $136.84 / $254.43	Professional	TC	$57.47	$136.84	$254.43
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $113.30 / $157.50 / $241.60	Professional		$113.30	$157.50	$241.60
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $76.92 / $102.01	Professional	26	$64.09	$76.92	$102.01
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $42.77 / $83.61 / $117.04	Professional	TC	$42.77	$83.61	$117.04