Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.26 / $79.26 / $146.66	Facility	26	$79.26	$79.26	$146.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.24 / $147.78 / $238.75	Professional		$126.24	$147.78	$238.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.87 / $79.26 / $112.45	Professional	26	$68.87	$79.26	$112.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.29 / $65.34 / $91.47	Professional	TC	$53.29	$65.34	$91.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.71 / $160.79 / $310.42	Professional		$121.71	$160.79	$310.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.05 / $72.05 / $109.81	Professional	26	$72.05	$72.05	$109.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.01 / $142.19 / $216.91	Professional		$128.01	$142.19	$216.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.31 / $80.63 / $126.25	Professional	26	$74.31	$80.63	$126.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.37 / $63.56 / $89.79	Professional	TC	$53.37	$63.56	$89.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.78 / $239.74 / $399.89	Professional		$154.78	$239.74	$399.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.56 / $135.69 / $229.04	Professional	26	$89.56	$135.69	$229.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.22 / $103.47 / $170.86	Professional	TC	$65.22	$103.47	$170.86
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $232.17 / $453.75	Professional		$139.66	$232.17	$453.75
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $85.91 / $141.62 / $265.16	Professional	26	$85.91	$141.62	$265.16
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $61.10 / $96.12 / $173.07	Professional	TC	$61.10	$96.12	$173.07
United Facility/Professional Professional Modifier Low / Median / High Price $163.56 / $233.36 / $495.53	Professional		$163.56	$233.36	$495.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.63 / $126.14 / $273.22	Professional	26	$88.63	$126.14	$273.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.25 / $118.72 / $222.31	Professional	TC	$72.25	$118.72	$222.31
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $115.41 / $138.49 / $203.58	Professional		$115.41	$138.49	$203.58
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $62.71 / $74.62 / $110.62	Professional	26	$62.71	$74.62	$110.62
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $52.70 / $62.71 / $92.96	Professional	TC	$52.70	$62.71	$92.96