Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.54 / $265.57 / $265.57	Facility	26	$65.54	$265.57	$265.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.07 / $340.04 / $1,057.67	Professional		$220.07	$340.04	$1,057.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.71 / $65.54 / $183.36	Professional	26	$53.71	$65.54	$183.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $166.36 / $277.86 / $874.28	Professional	TC	$166.36	$277.86	$874.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.20 / $167.20 / $167.20	Professional		$167.20	$167.20	$167.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.69 / $85.65 / $173.39	Professional	26	$58.69	$85.65	$173.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.37 / $464.42 / $670.49	Professional		$217.37	$464.42	$670.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.43 / $156.88 / $221.85	Professional	26	$73.43	$156.88	$221.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $143.94 / $307.54 / $440.98	Professional	TC	$143.94	$307.54	$440.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.08 / $86.08 / $86.08	Facility	26	$86.08	$86.08	$86.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $290.17 / $519.22 / $898.23	Professional		$290.17	$519.22	$898.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.47 / $152.10 / $225.94	Professional	26	$91.47	$152.10	$225.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.33 / $351.08 / $638.12	Professional	TC	$194.33	$351.08	$638.12
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $248.84 / $442.24 / $819.70	Professional		$248.84	$442.24	$819.70
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $84.06 / $149.07 / $276.89	Professional	26	$84.06	$149.07	$276.89
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $164.78 / $292.85 / $542.79	Professional	TC	$164.78	$292.85	$542.79
United Facility/Professional Professional Modifier Low / Median / High Price $307.73 / $348.12 / $762.77	Professional		$307.73	$348.12	$762.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.97 / $109.49 / $196.43	Professional	26	$70.97	$109.49	$196.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $206.66 / $246.58 / $569.03	Professional	TC	$206.66	$246.58	$569.03
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $195.27 / $268.69 / $372.41	Professional		$195.27	$268.69	$372.41
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $61.56 / $73.08 / $93.86	Professional	26	$61.56	$73.08	$93.86
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $132.69 / $164.55 / $294.33	Professional	TC	$132.69	$164.55	$294.33