Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	26	$251.19	$251.19	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $275.42 / $489.78	Professional		$199.53	$275.42	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $77.62 / $199.53	Professional	26	$54.95	$77.62	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $213.80 / $346.74	Professional	TC	$141.25	$213.80	$346.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $45.71 / $87.10	Professional	26	$45.71	$45.71	$87.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $457.09 / $660.69	Professional		$194.98	$457.09	$660.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $131.83 / $190.55	Professional	26	$57.54	$131.83	$190.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $323.59 / $512.86	Professional	TC	$138.04	$323.59	$512.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $81.28 / $81.28	Facility	26	$81.28	$81.28	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $467.74 / $933.25	Professional		$269.15	$467.74	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $125.89 / $199.53	Professional	26	$74.13	$125.89	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $338.84 / $758.58	Professional	TC	$194.98	$338.84	$758.58
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $354.81 / $537.03	Professional		$223.87	$354.81	$537.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $102.33 / $151.36	Professional	26	$66.07	$102.33	$151.36
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $251.19 / $371.54	Professional	TC	$162.18	$251.19	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $371.54 / $660.69	Professional		$234.42	$371.54	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $91.20 / $169.82	Professional	26	$63.10	$91.20	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $251.19 / $467.74	Professional	TC	$165.96	$251.19	$467.74
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $43.65 / $43.65	Facility	26	$37.15	$43.65	$43.65