Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.71 / $219.98 / $219.98	Facility	26	$84.71	$219.98	$219.98
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 $79.06 / $127.50 / $219.98	Professional	26	$79.06	$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 26 Low / Median / High Price $179.66 / $179.66 / $179.66	Professional	26	$179.66	$179.66	$179.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.16 / $478.93 / $694.44	Professional		$224.16	$478.93	$694.44
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 $169.82 / $362.83 / $526.10	Professional	TC	$169.82	$362.83	$526.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $310.95 / $550.13 / $1,150.00	Professional		$310.95	$550.13	$1,150.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.27 / $115.53 / $169.53	Professional	26	$69.27	$115.53	$169.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $237.21 / $422.01 / $1,009.55	Professional	TC	$237.21	$422.01	$1,009.55
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $267.42 / $509.08 / $845.33	Professional		$267.42	$509.08	$845.33
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $62.21 / $110.56 / $204.93	Professional	26	$62.21	$110.56	$204.93
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $194.41 / $345.51 / $640.41	Professional	TC	$194.41	$345.51	$640.41
United Facility/Professional Professional Modifier Low / Median / High Price $322.98 / $390.32 / $884.21	Professional		$322.98	$390.32	$884.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.69 / $79.76 / $160.50	Professional	26	$54.69	$79.76	$160.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $248.60 / $300.39 / $901.29	Professional	TC	$248.60	$300.39	$901.29
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $317.29 / $436.59 / $600.95	Professional		$317.29	$436.59	$600.95
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 $271.23 / $325.48 / $521.33	Professional	TC	$271.23	$325.48	$521.33