Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.26 / $247.02 / $247.02	Facility	26	$95.26	$247.02	$247.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $1,320.50	Professional		$370.50	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.49 / $127.50 / $247.02	Professional	26	$88.49	$127.50	$247.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $931.29	Professional	TC	$259.35	$335.00	$931.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.89 / $48.89 / $48.89	Professional	26	$48.89	$48.89	$48.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.22 / $474.79 / $688.44	Professional		$222.22	$474.79	$688.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.13 / $130.62 / $184.72	Professional	26	$61.13	$130.62	$184.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $161.09 / $344.17 / $493.50	Professional	TC	$161.09	$344.17	$493.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.04 / $100.04 / $100.04	Facility	26	$100.04	$100.04	$100.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $307.72 / $533.71 / $1,097.72	Professional		$307.72	$533.71	$1,097.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.34 / $128.66 / $188.93	Professional	26	$77.34	$128.66	$188.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $225.06 / $398.84 / $957.81	Professional	TC	$225.06	$398.84	$957.81
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $254.40 / $452.12 / $838.02	Professional		$254.40	$452.12	$838.02
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $69.98 / $124.39 / $230.55	Professional	26	$69.98	$124.39	$230.55
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $184.41 / $323.88 / $607.46	Professional	TC	$184.41	$323.88	$607.46
United Facility/Professional Professional Modifier Low / Median / High Price $328.57 / $413.00 / $1,131.24	Professional		$328.57	$413.00	$1,131.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.56 / $89.14 / $202.15	Professional	26	$61.56	$89.14	$202.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.43 / $294.49 / $723.59	Professional	TC	$245.43	$294.49	$723.59
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $277.14 / $381.36 / $524.91	Professional		$277.14	$381.36	$524.91
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $51.11 / $61.26 / $82.88	Professional	26	$51.11	$61.26	$82.88
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $225.67 / $270.80 / $427.42	Professional	TC	$225.67	$270.80	$427.42