Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.01 / $127.50 / $271.45	Facility	26	$104.01	$127.50	$271.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $311.70 / $425.00 / $1,320.50	Professional		$311.70	$425.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.31 / $127.50 / $271.45	Professional	26	$98.31	$127.50	$271.45
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $155.85 / $200.00 / $300.00	Professional	52	$155.85	$200.00	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.39 / $297.50 / $931.29	Professional	TC	$213.39	$297.50	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $145.09 / $154.11 / $456.92	Professional		$145.09	$154.11	$456.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.09 / $79.73 / $223.45	Professional	26	$54.09	$79.73	$223.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $99.73 / $99.73 / $99.73	Professional	TC	$99.73	$99.73	$99.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.26 / $402.22 / $583.21	Professional		$188.26	$402.22	$583.21
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 $120.65 / $257.77 / $369.63	Professional	TC	$120.65	$257.77	$369.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.63 / $88.63 / $88.63	Facility	26	$88.63	$88.63	$88.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.06 / $448.71 / $1,092.92	Professional		$258.06	$448.71	$1,092.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.06 / $143.55 / $208.93	Professional	26	$86.06	$143.55	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $168.30 / $296.70 / $892.93	Professional	TC	$168.30	$296.70	$892.93
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $215.51 / $383.00 / $709.91	Professional		$215.51	$383.00	$709.91
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $77.39 / $137.54 / $254.93	Professional	26	$77.39	$137.54	$254.93
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $138.12 / $245.47 / $454.98	Professional	TC	$138.12	$245.47	$454.98
United Facility/Professional Professional Modifier Low / Median / High Price $262.92 / $351.81 / $683.00	Professional		$262.92	$351.81	$683.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.09 / $100.02 / $202.13	Professional	26	$68.09	$100.02	$202.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.92 / $218.62 / $551.60	Professional	TC	$180.92	$218.62	$551.60
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $263.11 / $355.20 / $498.33	Professional		$263.11	$355.20	$498.33
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $56.75 / $68.03 / $92.02	Professional	26	$56.75	$68.03	$92.02
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $121.59 / $145.91 / $164.15	Professional	52	$121.59	$145.91	$164.15
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $204.47 / $247.14 / $390.78	Professional	TC	$204.47	$247.14	$390.78