Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.44 / $327.64 / $327.64	Facility	26	$127.44	$327.64	$327.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $451.43 / $1,320.50	Professional		$400.00	$451.43	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.49 / $127.50 / $327.64	Professional	26	$118.49	$127.50	$327.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $332.94 / $931.29	Professional	TC	$281.41	$332.94	$931.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.67 / $80.47 / $105.24	Professional	26	$65.67	$80.47	$105.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $266.20 / $568.78 / $815.57	Professional		$266.20	$568.78	$815.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.84 / $174.85 / $247.27	Professional	26	$81.84	$174.85	$247.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $184.38 / $393.93 / $564.85	Professional	TC	$184.38	$393.93	$564.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.71 / $106.71 / $106.71	Facility	26	$106.71	$106.71	$106.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $366.76 / $637.17 / $1,321.92	Professional		$366.76	$637.17	$1,321.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.49 / $172.89 / $250.85	Professional	26	$104.49	$172.89	$250.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.19 / $450.75 / $1,138.02	Professional	TC	$257.19	$450.75	$1,138.02
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $304.76 / $541.62 / $1,003.91	Professional		$304.76	$541.62	$1,003.91
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $93.69 / $166.15 / $308.62	Professional	26	$93.69	$166.15	$308.62
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $211.07 / $375.11 / $695.29	Professional	TC	$211.07	$375.11	$695.29
United Facility/Professional Professional Modifier Low / Median / High Price $390.89 / $488.61 / $968.88	Professional		$390.89	$488.61	$968.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.55 / $118.00 / $269.63	Professional	26	$87.55	$118.00	$269.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $280.18 / $320.10 / $645.66	Professional	TC	$280.18	$320.10	$645.66
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $434.44 / $521.33 / $766.35	Professional		$434.44	$521.33	$766.35
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $68.06 / $81.58 / $110.36	Professional	26	$68.06	$81.58	$110.36
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $363.26 / $435.41 / $595.73	Professional	TC	$363.26	$435.41	$595.73