Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.54 / $327.64 / $327.64	Facility	26	$126.54	$327.64	$327.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $451.70 / $1,320.50	Professional		$400.00	$451.70	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.49 / $127.50 / $327.64	Professional	26	$118.49	$127.50	$327.64
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $185.25 / $212.50 / $300.00	Professional	52	$185.25	$212.50	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $333.21 / $931.29	Professional	TC	$281.41	$333.21	$931.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.91 / $65.31 / $191.67	Professional	26	$64.91	$65.31	$191.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $266.54 / $569.47 / $816.56	Professional		$266.54	$569.47	$816.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.19 / $173.47 / $245.32	Professional	26	$81.19	$173.47	$245.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $185.35 / $396.00 / $567.82	Professional	TC	$185.35	$396.00	$567.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.71 / $106.71 / $106.71	Facility	26	$106.71	$106.71	$106.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $367.45 / $636.99 / $1,321.12	Professional		$367.45	$636.99	$1,321.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.67 / $172.54 / $249.96	Professional	26	$103.67	$172.54	$249.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $258.55 / $450.34 / $1,088.58	Professional	TC	$258.55	$450.34	$1,088.58
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $305.13 / $542.28 / $1,005.13	Professional		$305.13	$542.28	$1,005.13
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $92.95 / $165.19 / $306.19	Professional	26	$92.95	$165.19	$306.19
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $212.18 / $377.09 / $698.94	Professional	TC	$212.18	$377.09	$698.94
United Facility/Professional Professional Modifier Low / Median / High Price $323.86 / $470.43 / $978.96	Professional		$323.86	$470.43	$978.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.48 / $118.00 / $242.00	Professional	26	$81.48	$118.00	$242.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $277.92 / $324.24 / $639.95	Professional	TC	$277.92	$324.24	$639.95
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $331.04 / $446.90 / $626.99	Professional		$331.04	$446.90	$626.99
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $68.06 / $81.58 / $110.36	Professional	26	$68.06	$81.58	$110.36
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $133.16 / $159.80 / $179.78	Professional	52	$133.16	$159.80	$179.78
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $260.60 / $314.99 / $497.16	Professional	TC	$260.60	$314.99	$497.16