Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.35 / $219.98 / $219.98	Facility	26	$106.35	$219.98	$219.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $385.58 / $475.00 / $1,320.50	Professional		$385.58	$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 $279.22 / $335.00 / $931.29	Professional	TC	$279.22	$335.00	$931.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.61 / $54.61 / $54.61	Professional	26	$54.61	$54.61	$54.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $242.60 / $518.33 / $751.57	Professional		$242.60	$518.33	$751.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.25 / $145.82 / $206.21	Professional	26	$68.25	$145.82	$206.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $174.35 / $372.50 / $540.12	Professional	TC	$174.35	$372.50	$540.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.82 / $594.40 / $1,228.18	Professional		$335.82	$594.40	$1,228.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.38 / $139.94 / $210.92	Professional	26	$85.38	$139.94	$210.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $243.54 / $433.73 / $1,088.24	Professional	TC	$243.54	$433.73	$1,088.24
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $277.73 / $493.58 / $914.87	Professional		$277.73	$493.58	$914.87
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $78.13 / $138.56 / $257.37	Professional	26	$78.13	$138.56	$257.37
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $199.59 / $354.71 / $657.47	Professional	TC	$199.59	$354.71	$657.47
United Facility/Professional Professional Modifier Low / Median / High Price $346.30 / $418.44 / $1,137.73	Professional		$346.30	$418.44	$1,137.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.65 / $99.29 / $161.49	Professional	26	$57.65	$99.29	$161.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.10 / $303.69 / $980.26	Professional	TC	$253.10	$303.69	$980.26
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $350.24 / $481.93 / $663.35	Professional		$350.24	$481.93	$663.35
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $51.92 / $66.34 / $86.54	Professional	26	$51.92	$66.34	$86.54
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $292.55 / $351.06 / $554.09	Professional	TC	$292.55	$351.06	$554.09