Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $128.82 / $295.12	Facility	26	$112.20	$128.82	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $426.58 / $1,479.11	Professional		$208.93	$426.58	$1,479.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $123.03 / $234.42	Professional	26	$69.18	$123.03	$234.42
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $870.96 / $870.96 / $870.96	Professional	52	$870.96	$870.96	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $295.12 / $812.83	Professional	TC	$134.90	$295.12	$812.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $144.54 / $630.96	Professional		$74.13	$144.54	$630.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $87.10 / $223.87	Professional	26	$51.29	$87.10	$223.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $446.68 / $707.95	Professional		$190.55	$446.68	$707.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $158.49 / $229.09	Professional	26	$67.61	$158.49	$229.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $281.84 / $457.09	Professional	TC	$123.03	$281.84	$457.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $489.78 / $1,096.48	Professional		$257.04	$489.78	$1,096.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $151.36 / $218.78	Professional	26	$87.10	$151.36	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $309.03 / $933.25	Professional	TC	$169.82	$309.03	$933.25
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $346.74 / $537.03	Professional		$218.78	$346.74	$537.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $123.03 / $181.97	Professional	26	$79.43	$123.03	$181.97
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $229.09 / $346.74	Professional	TC	$144.54	$229.09	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $389.05 / $691.83	Professional		$218.78	$389.05	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $100.00 / $199.53	Professional	26	$72.44	$100.00	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $234.42 / $478.63	Professional	TC	$144.54	$234.42	$478.63
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $52.48 / $52.48	Facility	26	$44.67	$52.48	$52.48