Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.31 / $48.31 / $84.17	Facility	26	$48.31	$48.31	$84.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.93 / $96.71 / $216.35	Professional		$79.93	$96.71	$216.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.89 / $48.31 / $81.69	Professional	26	$39.89	$48.31	$81.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $325.39 / $325.39 / $347.20	Professional	50	$325.39	$325.39	$347.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.04 / $47.35 / $80.92	Professional	TC	$40.04	$47.35	$80.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.09 / $106.46 / $219.58	Professional		$86.09	$106.46	$219.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.94 / $62.94 / $62.94	Professional	26	$62.94	$62.94	$62.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.57 / $131.91 / $213.86	Professional		$90.57	$131.91	$213.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.02 / $62.66 / $93.06	Professional	26	$43.02	$62.66	$93.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.55 / $69.25 / $102.85	Professional	TC	$47.55	$69.25	$102.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.48 / $156.08 / $292.62	Professional		$109.48	$156.08	$292.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.34 / $74.42 / $131.81	Professional	26	$51.34	$74.42	$131.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.15 / $78.68 / $160.81	Professional	TC	$58.15	$78.68	$160.81
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $88.13 / $160.31 / $320.01	Professional		$88.13	$160.31	$320.01
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $49.25 / $82.00 / $152.01	Professional	26	$49.25	$82.00	$152.01
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $54.43 / $89.73 / $168.00	Professional	TC	$54.43	$89.73	$168.00
United Facility/Professional Professional Modifier Low / Median / High Price $109.76 / $147.97 / $331.58	Professional		$109.76	$147.97	$331.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.93 / $77.76 / $155.63	Professional	26	$54.93	$77.76	$155.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.72 / $77.12 / $175.94	Professional	TC	$56.72	$77.12	$175.94
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $77.45 / $92.95 / $136.63	Professional		$77.45	$92.95	$136.63
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $35.72 / $42.86 / $59.63	Professional	26	$35.72	$42.86	$59.63
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $39.82 / $48.75 / $67.20	Professional	TC	$39.82	$48.75	$67.20