Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.40 / $103.68 / $103.68	Facility	26	$49.40	$103.68	$103.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $83.82 / $166.02	Professional		$64.31	$83.82	$166.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.58 / $33.10 / $48.51	Professional	26	$29.58	$33.10	$48.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.89 / $50.72 / $81.61	Professional	TC	$32.89	$50.72	$81.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $331.35 / $331.35 / $331.35	Professional		$331.35	$331.35	$331.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $108.26 / $108.26 / $108.26	Professional	26	$108.26	$108.26	$108.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.33 / $143.21 / $223.40	Professional		$98.33	$143.21	$223.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.67 / $47.58 / $70.66	Professional	26	$32.67	$47.58	$70.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.66 / $95.63 / $142.03	Professional	TC	$65.66	$95.63	$142.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.98 / $151.19 / $317.66	Professional		$75.98	$151.19	$317.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.95 / $58.26 / $99.99	Professional	26	$38.95	$58.26	$99.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.84 / $103.06 / $217.67	Professional	TC	$47.84	$103.06	$217.67
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $112.57 / $184.68 / $347.45	Professional		$112.57	$184.68	$347.45
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $37.40 / $59.07 / $115.44	Professional	26	$37.40	$59.07	$115.44
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $75.17 / $123.92 / $232.01	Professional	TC	$75.17	$123.92	$232.01
United Facility/Professional Professional Modifier Low / Median / High Price $71.08 / $138.54 / $321.54	Professional		$71.08	$138.54	$321.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $52.46 / $117.56	Professional	26	$39.81	$52.46	$117.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.34 / $105.63 / $205.66	Professional	TC	$49.34	$105.63	$205.66
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $86.62 / $132.86	Professional		$54.55	$86.62	$132.86
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $32.35 / $42.59	Professional	26	$26.96	$32.35	$42.59
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $25.16 / $55.61 / $77.84	Professional	TC	$25.16	$55.61	$77.84