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 / $325.10	Facility	26	$79.75	$127.32	$325.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.52 / $385.88 / $1,199.43	Professional		$231.52	$385.88	$1,199.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.72 / $79.75 / $223.28	Professional	26	$64.72	$79.75	$223.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $166.81 / $310.24 / $976.14	Professional	TC	$166.81	$310.24	$976.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $313.29 / $313.29 / $313.29	Professional		$313.29	$313.29	$313.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.02 / $91.98 / $263.00	Professional	26	$61.02	$91.98	$263.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.80 / $581.22 / $833.41	Professional		$257.80	$581.22	$833.41
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 / $411.20 / $581.51	Professional	TC	$178.23	$411.20	$581.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $362.54 / $646.19 / $1,182.29	Professional		$362.54	$646.19	$1,182.29
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 $258.54 / $463.27 / $999.01	Professional	TC	$258.54	$463.27	$999.01
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $311.42 / $553.46 / $1,025.84	Professional		$311.42	$553.46	$1,025.84
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 $220.33 / $391.57 / $725.79	Professional	TC	$220.33	$391.57	$725.79
United Facility/Professional Professional Modifier Low / Median / High Price $372.90 / $466.13 / $1,794.75	Professional		$372.90	$466.13	$1,794.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.03 / $117.55 / $234.91	Professional	26	$80.03	$117.55	$234.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $264.39 / $313.75 / $567.95	Professional	TC	$264.39	$313.75	$567.95
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $213.45 / $293.70 / $631.01	Professional		$213.45	$293.70	$631.01
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $66.70 / $79.98 / $108.15	Professional	26	$66.70	$79.98	$108.15
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $146.28 / $181.39 / $551.03	Professional	TC	$146.28	$181.39	$551.03