Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.50 / $194.47 / $393.64	Facility	26	$127.50	$194.47	$393.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $475.00 / $1,320.50	Professional		$400.00	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.59 / $140.00 / $389.19	Professional	26	$118.59	$140.00	$389.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $931.29	Professional	TC	$281.41	$335.00	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $273.45 / $273.45 / $273.45	Professional		$273.45	$273.45	$273.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $78.92 / $126.44 / $324.74	Professional	26	$78.92	$126.44	$324.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $333.49 / $712.52 / $1,021.68	Professional		$333.49	$712.52	$1,021.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $98.33 / $210.09 / $297.10	Professional	26	$98.33	$210.09	$297.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $235.16 / $502.43 / $720.43	Professional	TC	$235.16	$502.43	$720.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $461.44 / $821.90 / $1,813.11	Professional		$461.44	$821.90	$1,813.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.61 / $206.61 / $300.89	Professional	26	$123.61	$206.61	$300.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $328.54 / $585.04 / $1,500.33	Professional	TC	$328.54	$585.04	$1,500.33
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $381.78 / $678.50 / $1,257.61	Professional		$381.78	$678.50	$1,257.61
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $112.57 / $200.06 / $370.82	Professional	26	$112.57	$200.06	$370.82
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $269.20 / $478.44 / $886.80	Professional	TC	$269.20	$478.44	$886.80
United Facility/Professional Professional Modifier Low / Median / High Price $490.40 / $681.06 / $1,358.34	Professional		$490.40	$681.06	$1,358.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.49 / $142.16 / $290.33	Professional	26	$98.49	$142.16	$290.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $297.77 / $400.67 / $1,030.01	Professional	TC	$297.77	$400.67	$1,030.01
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $471.81 / $608.01 / $893.61	Professional		$471.81	$608.01	$893.61
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $81.55 / $97.75 / $132.22	Professional	26	$81.55	$97.75	$132.22
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $386.86 / $467.60 / $738.03	Professional	TC	$386.86	$467.60	$738.03