Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.50 / $165.43 / $433.39	Facility	26	$127.50	$165.43	$433.39
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 / $140.00 / $389.19	Professional	26	$118.59	$140.00	$389.19
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 / $335.00 / $931.29	Professional	TC	$281.41	$335.00	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.35 / $257.23 / $762.69	Professional		$169.35	$257.23	$762.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.09 / $120.68 / $346.11	Professional	26	$80.09	$120.68	$346.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $173.01 / $173.01 / $173.01	Professional	TC	$173.01	$173.01	$173.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $314.08 / $671.06 / $962.23	Professional		$314.08	$671.06	$962.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.80 / $223.92 / $316.66	Professional	26	$104.80	$223.92	$316.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $209.28 / $447.14 / $641.15	Professional	TC	$209.28	$447.14	$641.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.34 / $142.34 / $142.34	Facility	26	$142.34	$142.34	$142.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $431.50 / $749.47 / $1,749.08	Professional		$431.50	$749.47	$1,749.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $133.99 / $220.79 / $320.87	Professional	26	$133.99	$220.79	$320.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $291.95 / $516.45 / $1,511.76	Professional	TC	$291.95	$516.45	$1,511.76
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $359.56 / $639.01 / $1,184.43	Professional		$359.56	$639.01	$1,184.43
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $119.98 / $213.23 / $395.23	Professional	26	$119.98	$213.23	$395.23
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $239.58 / $425.78 / $789.20	Professional	TC	$239.58	$425.78	$789.20
United Facility/Professional Professional Modifier Low / Median / High Price $458.95 / $554.57 / $1,291.02	Professional		$458.95	$554.57	$1,291.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.59 / $152.47 / $344.42	Professional	26	$107.59	$152.47	$344.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $258.76 / $380.02 / $1,034.66	Professional	TC	$258.76	$380.02	$1,034.66
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $465.47 / $602.04 / $881.60	Professional		$465.47	$602.04	$881.60
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $88.08 / $107.02 / $141.80	Professional	26	$88.08	$107.02	$141.80
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $237.23 / $284.68 / $320.26	Professional	52	$237.23	$284.68	$320.26
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $374.67 / $452.87 / $714.78	Professional	TC	$374.67	$452.87	$714.78