Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $157.50 / $417.56 / $417.56	Facility	26	$157.50	$417.56	$417.56
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 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 $247.06 / $1,122.05 / $1,122.05	Professional		$247.06	$1,122.05	$1,122.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.12 / $133.08 / $133.08	Professional	26	$83.12	$133.08	$133.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $460.61 / $986.20 / $1,408.22	Professional		$460.61	$986.20	$1,408.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.51 / $221.15 / $312.75	Professional	26	$103.51	$221.15	$312.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $357.11 / $765.05 / $1,081.93	Professional	TC	$357.11	$765.05	$1,081.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $639.96 / $1,110.96 / $2,060.08	Professional		$639.96	$1,110.96	$2,060.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $130.22 / $218.02 / $316.86	Professional	26	$130.22	$218.02	$316.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $499.60 / $884.77 / $1,786.14	Professional	TC	$499.60	$884.77	$1,786.14
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $528.41 / $939.11 / $1,740.67	Professional		$528.41	$939.11	$1,740.67
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $118.50 / $210.60 / $390.35	Professional	26	$118.50	$210.60	$390.35
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $409.92 / $728.51 / $1,350.32	Professional	TC	$409.92	$728.51	$1,350.32
United Facility/Professional Professional Modifier Low / Median / High Price $698.65 / $843.42 / $1,601.31	Professional		$698.65	$843.42	$1,601.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.24 / $144.03 / $305.60	Professional	26	$110.24	$144.03	$305.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $466.24 / $676.04 / $1,437.25	Professional	TC	$466.24	$676.04	$1,437.25
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $538.57 / $691.23 / $1,020.05	Professional		$538.57	$691.23	$1,020.05
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $85.59 / $102.59 / $138.79	Professional	26	$85.59	$102.59	$138.79
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $449.11 / $542.83 / $856.77	Professional	TC	$449.11	$542.83	$856.77