Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.54 / $138.13 / $138.13	Facility	26	$63.54	$138.13	$138.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.52 / $86.17 / $114.18	Professional		$75.52	$86.17	$114.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $43.52 / $57.37	Professional	26	$38.81	$43.52	$57.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.82 / $42.33 / $50.82	Professional	TC	$34.82	$42.33	$50.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $280.95 / $280.95 / $280.95	Professional		$280.95	$280.95	$280.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.78 / $122.01 / $196.54	Professional		$83.78	$122.01	$196.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.05 / $61.24 / $90.95	Professional	26	$42.05	$61.24	$90.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.73 / $60.77 / $90.25	Professional	TC	$41.73	$60.77	$90.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.20 / $143.15 / $261.82	Professional		$81.20	$143.15	$261.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.10 / $76.64 / $129.63	Professional	26	$50.10	$76.64	$129.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.36 / $66.06 / $132.18	Professional	TC	$36.36	$66.06	$132.18
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $150.69 / $296.02	Professional		$90.73	$150.69	$296.02
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $48.14 / $80.67 / $148.58	Professional	26	$48.14	$80.67	$148.58
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $47.77 / $78.37 / $147.44	Professional	TC	$47.77	$78.37	$147.44
United Facility/Professional Professional Modifier Low / Median / High Price $87.70 / $125.90 / $292.20	Professional		$87.70	$125.90	$292.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.88 / $76.97 / $152.97	Professional	26	$50.88	$76.97	$152.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.39 / $62.13 / $139.22	Professional	TC	$38.39	$62.13	$139.22
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $78.25 / $113.82	Professional		$38.54	$78.25	$113.82
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $42.05 / $56.41	Professional	26	$34.79	$42.05	$56.41
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $30.30 / $37.95 / $58.21	Professional	TC	$30.30	$37.95	$58.21