Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $128.82 / $269.15	Facility	26	$104.71	$128.82	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $426.58 / $1,548.82	Professional		$213.80	$426.58	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $107.15 / $229.09	Professional	26	$67.61	$107.15	$229.09
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $120.23 / $128.82 / $269.15	Professional	52	$120.23	$128.82	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $281.84 / $588.84	Professional	TC	$138.04	$281.84	$588.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $151.36 / $467.74	Professional		$138.04	$151.36	$467.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $85.11 / $223.87	Professional	26	$51.29	$85.11	$223.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $107.15 / $234.42	Professional	TC	$107.15	$107.15	$234.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $457.09 / $707.95	Professional		$194.98	$457.09	$707.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $158.49 / $229.09	Professional	26	$67.61	$158.49	$229.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $295.12 / $467.74	Professional	TC	$128.82	$295.12	$467.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $501.19 / $1,230.27	Professional		$269.15	$501.19	$1,230.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $147.91 / $213.80	Professional	26	$87.10	$147.91	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $323.59 / $977.24	Professional	TC	$177.83	$323.59	$977.24
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $354.81 / $562.34	Professional		$223.87	$354.81	$562.34
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $123.03 / $186.21	Professional	26	$77.62	$123.03	$186.21
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $234.42 / $363.08	Professional	TC	$147.91	$234.42	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $389.05 / $707.95	Professional		$229.09	$389.05	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $100.00 / $199.53	Professional	26	$67.61	$100.00	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $234.42 / $489.78	Professional	TC	$151.36	$234.42	$489.78
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $52.48 / $52.48	Facility	26	$44.67	$52.48	$52.48