Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.35 / $127.50 / $293.95	Facility	26	$105.35	$127.50	$293.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.26 / $425.00 / $1,320.50	Professional		$313.26	$425.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.79 / $127.50 / $293.95	Professional	26	$97.79	$127.50	$293.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $215.47 / $297.50 / $931.29	Professional	TC	$215.47	$297.50	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $153.84 / $228.07 / $228.07	Professional		$153.84	$228.07	$228.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.09 / $87.00 / $223.45	Professional	26	$54.09	$87.00	$223.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $187.93 / $401.53 / $582.21	Professional		$187.93	$401.53	$582.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.59 / $144.44 / $204.26	Professional	26	$67.59	$144.44	$204.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.33 / $257.08 / $371.28	Professional	TC	$120.33	$257.08	$371.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.07 / $96.07 / $96.07	Facility	26	$96.07	$96.07	$96.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.60 / $446.63 / $1,109.08	Professional		$257.60	$446.63	$1,109.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.58 / $143.55 / $209.97	Professional	26	$86.58	$143.55	$209.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.85 / $295.95 / $893.91	Professional	TC	$167.85	$295.95	$893.91
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $215.14 / $381.53 / $708.69	Professional		$215.14	$381.53	$708.69
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $77.39 / $133.87 / $254.93	Professional	26	$77.39	$133.87	$254.93
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $137.75 / $244.81 / $453.76	Professional	TC	$137.75	$244.81	$453.76
United Facility/Professional Professional Modifier Low / Median / High Price $272.81 / $330.77 / $686.28	Professional		$272.81	$330.77	$686.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.16 / $99.00 / $201.14	Professional	26	$73.16	$99.00	$201.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.48 / $216.54 / $551.60	Professional	TC	$180.48	$216.54	$551.60
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $263.24 / $355.37 / $498.58	Professional		$263.24	$355.37	$498.58
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $57.16 / $70.88 / $92.27	Professional	26	$57.16	$70.88	$92.27
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $204.60 / $247.30 / $391.14	Professional	TC	$204.60	$247.30	$391.14