Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.01 / $151.26 / $195.73	Facility	26	$106.01	$151.26	$195.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.07 / $190.30 / $312.52	Professional		$168.07	$190.30	$312.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.25 / $106.01 / $150.72	Professional	26	$92.25	$106.01	$150.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.17 / $84.29 / $116.82	Professional	TC	$68.17	$84.29	$116.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $159.06 / $210.41 / $405.68	Professional		$159.06	$210.41	$405.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $146.22 / $146.22 / $146.22	Professional	26	$146.22	$146.22	$146.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.88 / $185.69 / $283.57	Professional		$167.88	$185.69	$283.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $98.92 / $107.63 / $168.16	Professional	26	$98.92	$107.63	$168.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.93 / $81.62 / $114.28	Professional	TC	$67.93	$81.62	$114.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.28 / $313.58 / $523.04	Professional		$202.28	$313.58	$523.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.27 / $181.44 / $304.36	Professional	26	$119.27	$181.44	$304.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.02 / $137.41 / $218.69	Professional	TC	$83.02	$137.41	$218.69
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $192.19 / $313.08 / $593.19	Professional		$192.19	$313.08	$593.19
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $114.42 / $188.22 / $353.16	Professional	26	$114.42	$188.22	$353.16
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $77.76 / $126.67 / $240.01	Professional	TC	$77.76	$126.67	$240.01
United Facility/Professional Professional Modifier Low / Median / High Price $217.76 / $320.93 / $651.72	Professional		$217.76	$320.93	$651.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $122.28 / $168.81 / $350.73	Professional	26	$122.28	$168.81	$350.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.60 / $135.93 / $285.86	Professional	TC	$92.60	$135.93	$285.86
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $151.72 / $182.08 / $267.64	Professional		$151.72	$182.08	$267.64
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $83.95 / $99.90 / $148.09	Professional	26	$83.95	$99.90	$148.09
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $67.78 / $80.66 / $119.56	Professional	TC	$67.78	$80.66	$119.56