Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.97 / $352.04 / $352.04	Facility	26	$127.97	$352.04	$352.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $457.14 / $600.00	Professional		$370.50	$457.14	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $127.50 / $140.00	Professional	26	$111.15	$127.50	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $480.00	Professional	TC	$259.35	$335.00	$480.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.09 / $65.91 / $65.91	Professional	26	$62.09	$65.91	$65.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $271.06 / $579.14 / $830.42	Professional		$271.06	$579.14	$830.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.16 / $175.54 / $248.24	Professional	26	$82.16	$175.54	$248.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $188.90 / $403.60 / $578.72	Professional	TC	$188.90	$403.60	$578.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.91 / $114.91 / $114.91	Facility	26	$114.91	$114.91	$114.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.66 / $648.58 / $1,335.18	Professional		$373.66	$648.58	$1,335.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.16 / $173.20 / $251.88	Professional	26	$105.16	$173.20	$251.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.51 / $461.41 / $1,116.15	Professional	TC	$263.51	$461.41	$1,116.15
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $310.31 / $551.48 / $1,022.19	Professional		$310.31	$551.48	$1,022.19
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $94.06 / $154.72 / $290.32	Professional	26	$94.06	$154.72	$290.32
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $216.26 / $384.34 / $712.38	Professional	TC	$216.26	$384.34	$712.38
United Facility/Professional Professional Modifier Low / Median / High Price $397.21 / $622.53 / $1,104.05	Professional		$397.21	$622.53	$1,104.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.37 / $118.51 / $242.00	Professional	26	$88.37	$118.51	$242.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $286.05 / $333.73 / $662.90	Professional	TC	$286.05	$333.73	$662.90
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $436.30 / $523.55 / $769.63	Professional		$436.30	$523.55	$769.63
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $68.84 / $85.36 / $111.30	Professional	26	$68.84	$85.36	$111.30
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $364.81 / $437.27 / $597.11	Professional	TC	$364.81	$437.27	$597.11