Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.98 / $127.50 / $219.98	Facility	26	$83.98	$127.50	$219.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $391.93 / $475.00 / $1,320.50	Professional		$391.93	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.59 / $127.50 / $219.98	Professional	26	$79.59	$127.50	$219.98
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 $163.05 / $163.05 / $163.05	Professional		$163.05	$163.05	$163.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.41 / $53.47 / $179.66	Professional	26	$43.41	$53.47	$179.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.19 / $453.36 / $657.37	Professional		$212.19	$453.36	$657.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.34 / $116.10 / $164.18	Professional	26	$54.34	$116.10	$164.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $157.85 / $337.26 / $489.02	Professional	TC	$157.85	$337.26	$489.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.94 / $520.65 / $1,159.35	Professional		$293.94	$520.65	$1,159.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.27 / $116.10 / $169.53	Professional	26	$69.27	$116.10	$169.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.48 / $391.76 / $1,020.27	Professional	TC	$220.48	$391.76	$1,020.27
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $242.92 / $426.64 / $800.20	Professional		$242.92	$426.64	$800.20
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $62.21 / $107.61 / $204.93	Professional	26	$62.21	$107.61	$204.93
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $180.71 / $321.16 / $595.28	Professional	TC	$180.71	$321.16	$595.28
United Facility/Professional Professional Modifier Low / Median / High Price $308.99 / $386.24 / $1,085.28	Professional		$308.99	$386.24	$1,085.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.13 / $79.27 / $161.49	Professional	26	$55.13	$79.27	$161.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.61 / $281.50 / $922.08	Professional	TC	$234.61	$281.50	$922.08
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $295.37 / $406.43 / $578.94	Professional		$295.37	$406.43	$578.94
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $45.73 / $54.81 / $74.15	Professional	26	$45.73	$54.81	$74.15
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $247.51 / $299.17 / $524.63	Professional	TC	$247.51	$299.17	$524.63