Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.22 / $219.98 / $219.98	Facility	26	$85.22	$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 $79.31 / $127.50 / $219.98	Professional	26	$79.31	$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 $43.65 / $45.98 / $129.06	Professional	26	$43.65	$45.98	$129.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.84 / $454.74 / $659.37	Professional		$212.84	$454.74	$659.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.67 / $116.80 / $165.17	Professional	26	$54.67	$116.80	$165.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.16 / $337.95 / $490.02	Professional	TC	$158.16	$337.95	$490.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.85 / $521.42 / $1,161.06	Professional		$294.85	$521.42	$1,161.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.27 / $116.29 / $169.53	Professional	26	$69.27	$116.29	$169.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.93 / $392.54 / $1,021.12	Professional	TC	$220.93	$392.54	$1,021.12
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $243.66 / $433.03 / $802.64	Professional		$243.66	$433.03	$802.64
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $62.58 / $111.22 / $206.14	Professional	26	$62.58	$111.22	$206.14
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $181.08 / $321.82 / $596.50	Professional	TC	$181.08	$321.82	$596.50
United Facility/Professional Professional Modifier Low / Median / High Price $310.33 / $399.57 / $1,083.55	Professional		$310.33	$399.57	$1,083.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.69 / $80.22 / $163.21	Professional	26	$54.69	$80.22	$163.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $235.51 / $284.58 / $922.87	Professional	TC	$235.51	$284.58	$922.87
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $296.18 / $407.54 / $577.48	Professional		$296.18	$407.54	$577.48
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $46.02 / $55.16 / $74.62	Professional	26	$46.02	$55.16	$74.62
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $248.03 / $299.80 / $523.15	Professional	TC	$248.03	$299.80	$523.15