Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.50 / $207.84 / $470.99	Facility	26	$127.50	$207.84	$470.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $475.00 / $1,320.50	Professional		$400.00	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.59 / $140.00 / $389.19	Professional	26	$118.59	$140.00	$389.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $931.29	Professional	TC	$281.41	$335.00	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $256.48 / $258.04 / $382.53	Professional		$256.48	$258.04	$382.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $84.38 / $135.18 / $347.19	Professional	26	$84.38	$135.18	$347.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $173.55 / $173.55 / $173.55	Professional	TC	$173.55	$173.55	$173.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $315.05 / $673.13 / $965.20	Professional		$315.05	$673.13	$965.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $105.13 / $224.61 / $317.64	Professional	26	$105.13	$224.61	$317.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $209.93 / $448.52 / $643.13	Professional	TC	$209.93	$448.52	$643.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.12 / $154.12 / $154.12	Facility	26	$154.12	$154.12	$154.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $432.88 / $753.27 / $1,761.15	Professional		$432.88	$753.27	$1,761.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.44 / $221.48 / $325.00	Professional	26	$134.44	$221.48	$325.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $292.86 / $515.65 / $1,488.33	Professional	TC	$292.86	$515.65	$1,488.33
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $360.67 / $640.98 / $1,188.08	Professional		$360.67	$640.98	$1,188.08
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $120.35 / $213.89 / $396.44	Professional	26	$120.35	$213.89	$396.44
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $240.32 / $427.10 / $791.64	Professional	TC	$240.32	$427.10	$791.64
United Facility/Professional Professional Modifier Low / Median / High Price $462.56 / $642.40 / $1,302.54	Professional		$462.56	$642.40	$1,302.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.37 / $183.11 / $328.54	Professional	26	$117.37	$183.11	$328.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $320.33 / $384.36 / $1,031.16	Professional	TC	$320.33	$384.36	$1,031.16
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $466.25 / $601.69 / $883.08	Professional		$466.25	$601.69	$883.08
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $88.08 / $109.22 / $148.16	Professional	26	$88.08	$109.22	$148.16
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $375.45 / $453.80 / $716.25	Professional	TC	$375.45	$453.80	$716.25