Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.50 / $196.47 / $330.29	Facility	26	$127.50	$196.47	$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 $118.59 / $127.50 / $330.29	Professional	26	$118.59	$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 Low / Median / High Price $828.66 / $828.66 / $828.66	Professional		$828.66	$828.66	$828.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.43 / $80.51 / $105.33	Professional	26	$65.43	$80.51	$105.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.29 / $727.04 / $1,054.20	Professional		$340.29	$727.04	$1,054.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.84 / $174.85 / $247.27	Professional	26	$81.84	$174.85	$247.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $258.45 / $552.19 / $800.67	Professional	TC	$258.45	$552.19	$800.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $472.18 / $836.22 / $2,015.48	Professional		$472.18	$836.22	$2,015.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.49 / $173.96 / $254.30	Professional	26	$104.49	$173.96	$254.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $361.04 / $642.98 / $1,765.19	Professional	TC	$361.04	$642.98	$1,765.19
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $389.56 / $692.33 / $1,283.25	Professional		$389.56	$692.33	$1,283.25
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $93.69 / $166.51 / $308.62	Professional	26	$93.69	$166.51	$308.62
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $295.87 / $525.82 / $974.63	Professional	TC	$295.87	$525.82	$974.63
United Facility/Professional Professional Modifier Low / Median / High Price $491.46 / $682.53 / $1,657.68	Professional		$491.46	$682.53	$1,657.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.66 / $123.59 / $610.61	Professional	26	$84.66	$123.59	$610.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $327.27 / $474.30 / $1,296.89	Professional	TC	$327.27	$474.30	$1,296.89
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $501.87 / $690.57 / $950.54	Professional		$501.87	$690.57	$950.54
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $68.87 / $82.55 / $111.68	Professional	26	$68.87	$82.55	$111.68
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $429.39 / $519.00 / $833.99	Professional	TC	$429.39	$519.00	$833.99