Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.98 / $139.86 / $139.86	Facility	26	$63.98	$139.86	$139.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.25 / $145.77 / $197.16	Professional		$115.25	$145.77	$197.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $43.90 / $57.37	Professional	26	$40.09	$43.90	$57.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.14 / $104.68 / $153.26	Professional	TC	$75.14	$104.68	$153.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $384.18 / $384.18 / $384.18	Professional		$384.18	$384.18	$384.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.18 / $135.94 / $229.64	Professional		$114.18	$135.94	$229.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.09 / $47.74 / $83.30	Professional	26	$42.09	$47.74	$83.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.81 / $84.91 / $143.85	Professional	TC	$71.81	$84.91	$143.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.21 / $225.25 / $446.27	Professional		$138.21	$225.25	$446.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.44 / $77.26 / $129.63	Professional	26	$50.44	$77.26	$129.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.17 / $153.51 / $295.07	Professional	TC	$78.17	$153.51	$295.07
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $130.72 / $214.46 / $403.47	Professional		$130.72	$214.46	$403.47
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $48.51 / $79.80 / $149.72	Professional	26	$48.51	$79.80	$149.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $82.21 / $135.24 / $253.74	Professional	TC	$82.21	$135.24	$253.74
United Facility/Professional Professional Modifier Low / Median / High Price $141.94 / $183.72 / $439.91	Professional		$141.94	$183.72	$439.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.66 / $76.45 / $155.28	Professional	26	$51.66	$76.45	$155.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.60 / $118.44 / $284.63	Professional	TC	$87.60	$118.44	$284.63
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $103.02 / $123.62 / $195.12	Professional		$103.02	$123.62	$195.12
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $35.53 / $42.64 / $57.20	Professional	26	$35.53	$42.64	$57.20
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $67.01 / $80.31 / $119.05	Professional	TC	$67.01	$80.31	$119.05