Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.78 / $77.54 / $209.42	Facility	26	$51.78	$77.54	$209.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.31 / $236.33 / $703.89	Professional		$110.31	$236.33	$703.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.57 / $51.78 / $145.00	Professional	26	$31.57	$51.78	$145.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $55.16 / $72.31 / $160.00	Professional	52	$55.16	$72.31	$160.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.75 / $184.55 / $558.89	Professional	TC	$78.75	$184.55	$558.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.87 / $103.43 / $306.68	Professional		$96.87	$103.43	$306.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.30 / $50.38 / $129.40	Professional	26	$31.30	$50.38	$129.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.15 / $269.52 / $386.47	Professional		$126.15	$269.52	$386.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.14 / $83.62 / $119.90	Professional	26	$39.14	$83.62	$119.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.01 / $185.91 / $262.91	Professional	TC	$87.01	$185.91	$262.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.44 / $67.44 / $67.44	Facility	26	$67.44	$67.44	$67.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.07 / $300.17 / $549.25	Professional		$168.07	$300.17	$549.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.61 / $89.13 / $137.44	Professional	26	$50.61	$89.13	$137.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $116.90 / $210.54 / $423.75	Professional	TC	$116.90	$210.54	$423.75
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $144.41 / $256.66 / $475.73	Professional		$144.41	$256.66	$475.73
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $44.81 / $79.64 / $147.61	Professional	26	$44.81	$79.64	$147.61
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $99.61 / $177.03 / $328.13	Professional	TC	$99.61	$177.03	$328.13
United Facility/Professional Professional Modifier Low / Median / High Price $175.20 / $268.85 / $456.87	Professional		$175.20	$268.85	$456.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.11 / $56.89 / $108.74	Professional	26	$52.11	$56.89	$108.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.81 / $147.19 / $275.23	Professional	TC	$121.81	$147.19	$275.23
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $111.26 / $153.09 / $249.73	Professional		$111.26	$153.09	$249.73
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $33.04 / $42.90 / $62.60	Professional	26	$33.04	$42.90	$62.60
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $51.80 / $62.16 / $69.93	Professional	52	$51.80	$62.16	$69.93
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $78.20 / $93.85 / $198.25	Professional	TC	$78.20	$93.85	$198.25