Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.75 / $127.32 / $323.72	Facility	26	$79.75	$127.32	$323.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.98 / $402.06 / $1,199.43	Professional		$232.98	$402.06	$1,199.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.01 / $79.75 / $223.28	Professional	26	$65.01	$79.75	$223.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $167.97 / $310.24 / $976.14	Professional	TC	$167.97	$310.24	$976.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $209.03 / $626.59 / $626.59	Professional		$209.03	$626.59	$626.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.02 / $66.54 / $263.00	Professional	26	$61.02	$66.54	$263.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.80 / $550.80 / $789.80	Professional		$257.80	$550.80	$789.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.56 / $170.01 / $240.42	Professional	26	$79.56	$170.01	$240.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $178.23 / $411.90 / $582.50	Professional	TC	$178.23	$411.90	$582.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $362.97 / $646.95 / $1,183.70	Professional		$362.97	$646.95	$1,183.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.53 / $167.89 / $244.92	Professional	26	$101.53	$167.89	$244.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $258.97 / $464.03 / $1,002.47	Professional	TC	$258.97	$464.03	$1,002.47
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $311.79 / $554.11 / $1,027.07	Professional		$311.79	$554.11	$1,027.07
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $91.09 / $161.88 / $300.06	Professional	26	$91.09	$161.88	$300.06
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $220.70 / $392.23 / $727.01	Professional	TC	$220.70	$392.23	$727.01
United Facility/Professional Professional Modifier Low / Median / High Price $373.34 / $452.03 / $806.88	Professional		$373.34	$452.03	$806.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.03 / $116.35 / $235.90	Professional	26	$80.03	$116.35	$235.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.12 / $320.01 / $676.51	Professional	TC	$244.12	$320.01	$676.51
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $213.45 / $293.70 / $629.54	Professional		$213.45	$293.70	$629.54
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $66.70 / $79.94 / $108.15	Professional	26	$66.70	$79.94	$108.15
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $146.28 / $181.39 / $549.91	Professional	TC	$146.28	$181.39	$549.91