Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.83 / $266.88 / $266.88	Facility	26	$103.83	$266.88	$266.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $381.84 / $475.00 / $1,320.50	Professional		$381.84	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.36 / $127.50 / $266.88	Professional	26	$96.36	$127.50	$266.88
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 $271.02 / $271.02 / $271.02	Professional		$271.02	$271.02	$271.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.59 / $157.30 / $220.23	Professional	26	$53.59	$157.30	$220.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $308.58 / $704.23 / $1,009.79	Professional		$308.58	$704.23	$1,009.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.63 / $142.37 / $201.33	Professional	26	$66.63	$142.37	$201.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $241.95 / $561.86 / $794.58	Professional	TC	$241.95	$561.86	$794.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.44 / $108.44 / $108.44	Facility	26	$108.44	$108.44	$108.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.34 / $793.52 / $1,357.32	Professional		$457.34	$793.52	$1,357.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.68 / $141.36 / $204.88	Professional	26	$83.68	$141.36	$204.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $366.91 / $650.24 / $1,177.98	Professional	TC	$366.91	$650.24	$1,177.98
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $377.34 / $670.61 / $1,243.00	Professional		$377.34	$670.61	$1,243.00
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $76.28 / $135.56 / $251.27	Professional	26	$76.28	$135.56	$251.27
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $301.05 / $535.03 / $991.69	Professional	TC	$301.05	$535.03	$991.69
United Facility/Professional Professional Modifier Low / Median / High Price $417.38 / $599.16 / $1,274.31	Professional		$417.38	$599.16	$1,274.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.28 / $98.60 / $197.38	Professional	26	$66.28	$98.60	$197.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $333.00 / $468.13 / $950.66	Professional	TC	$333.00	$468.13	$950.66
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $333.21 / $455.47 / $631.10	Professional		$333.21	$455.47	$631.10
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $55.94 / $67.04 / $90.70	Professional	26	$55.94	$67.04	$90.70
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $274.87 / $332.24 / $524.39	Professional	TC	$274.87	$332.24	$524.39