Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.70 / $260.27 / $260.27	Facility	26	$89.70	$260.27	$260.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.47 / $349.43 / $1,087.48	Professional		$161.47	$349.43	$1,087.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.93 / $64.00 / $179.89	Professional	26	$46.93	$64.00	$179.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.55 / $288.44 / $907.58	Professional	TC	$114.55	$288.44	$907.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.40 / $147.40 / $147.40	Professional		$147.40	$147.40	$147.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.09 / $46.09 / $46.09	Professional	26	$46.09	$46.09	$46.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.14 / $387.02 / $554.94	Professional		$181.14	$387.02	$554.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.58 / $123.02 / $173.97	Professional	26	$57.58	$123.02	$173.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.56 / $264.00 / $373.34	Professional	TC	$123.56	$264.00	$373.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.53 / $84.53 / $84.53	Facility	26	$84.53	$84.53	$84.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.08 / $432.83 / $800.00	Professional		$242.08	$432.83	$800.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.68 / $123.00 / $179.71	Professional	26	$73.68	$123.00	$179.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $166.99 / $303.07 / $640.88	Professional	TC	$166.99	$303.07	$640.88
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $207.37 / $358.71 / $683.10	Professional		$207.37	$358.71	$683.10
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $65.91 / $114.01 / $217.11	Professional	26	$65.91	$114.01	$217.11
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $141.44 / $250.85 / $465.95	Professional	TC	$141.44	$250.85	$465.95
United Facility/Professional Professional Modifier Low / Median / High Price $256.08 / $310.19 / $559.29	Professional		$256.08	$310.19	$559.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.81 / $83.98 / $171.75	Professional	26	$64.81	$83.98	$171.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.47 / $214.26 / $433.59	Professional	TC	$156.47	$214.26	$433.59
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $162.63 / $223.79 / $367.84	Professional		$162.63	$223.79	$367.84
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $48.78 / $60.49 / $81.69	Professional	26	$48.78	$60.49	$81.69
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $113.86 / $136.63 / $303.50	Professional	TC	$113.86	$136.63	$303.50