Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.83 / $330.29 / $330.29	Facility	26	$104.83	$330.29	$330.29
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 $111.15 / $127.50 / $330.29	Professional	26	$111.15	$127.50	$330.29
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 $53.85 / $66.19 / $86.57	Professional	26	$53.85	$66.19	$86.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $324.76 / $693.86 / $1,006.09	Professional		$324.76	$693.86	$1,006.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.28 / $143.75 / $203.29	Professional	26	$67.28	$143.75	$203.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.48 / $550.12 / $797.67	Professional	TC	$257.48	$550.12	$797.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $451.11 / $798.24 / $1,951.20	Professional		$451.11	$798.24	$1,951.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.92 / $142.79 / $252.33	Professional	26	$87.92	$142.79	$252.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $359.68 / $639.85 / $1,765.19	Professional	TC	$359.68	$639.85	$1,765.19
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $371.78 / $660.73 / $1,224.68	Professional		$371.78	$660.73	$1,224.68
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $77.02 / $136.88 / $253.71	Professional	26	$77.02	$136.88	$253.71
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $294.88 / $523.85 / $970.97	Professional	TC	$294.88	$523.85	$970.97
United Facility/Professional Professional Modifier Low / Median / High Price $469.06 / $528.77 / $1,656.14	Professional		$469.06	$528.77	$1,656.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.17 / $100.02 / $242.56	Professional	26	$82.17	$100.02	$242.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $376.73 / $455.21 / $1,412.26	Professional	TC	$376.73	$455.21	$1,412.26
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $488.62 / $672.34 / $925.45	Professional		$488.62	$672.34	$925.45
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $57.16 / $71.45 / $103.65	Professional	26	$57.16	$71.45	$103.65
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $428.36 / $517.75 / $833.99	Professional	TC	$428.36	$517.75	$833.99