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 / $472.34	Facility	26	$127.50	$207.84	$472.34
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 $257.00 / $258.57 / $766.65	Professional		$257.00	$258.57	$766.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $87.87 / $195.79 / $347.19	Professional	26	$87.87	$195.79	$347.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $315.70 / $674.51 / $967.17	Professional		$315.70	$674.51	$967.17
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 $210.58 / $449.91 / $645.12	Professional	TC	$210.58	$449.91	$645.12
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 $433.80 / $754.79 / $1,700.74	Professional		$433.80	$754.79	$1,700.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.44 / $220.79 / $321.89	Professional	26	$134.44	$220.79	$321.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $293.76 / $515.77 / $1,390.10	Professional	TC	$293.76	$515.77	$1,390.10
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $361.41 / $625.16 / $1,190.52	Professional		$361.41	$625.16	$1,190.52
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $120.35 / $198.40 / $396.44	Professional	26	$120.35	$198.40	$396.44
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $241.07 / $428.43 / $794.11	Professional	TC	$241.07	$428.43	$794.11
United Facility/Professional Professional Modifier Low / Median / High Price $399.77 / $596.71 / $1,302.54	Professional		$399.77	$596.71	$1,302.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.94 / $152.47 / $310.29	Professional	26	$116.94	$152.47	$310.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $321.24 / $385.44 / $1,014.03	Professional	TC	$321.24	$385.44	$1,014.03
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $466.51 / $568.38 / $852.57	Professional		$466.51	$568.38	$852.57
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $88.08 / $109.22 / $147.66	Professional	26	$88.08	$109.22	$147.66
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $375.71 / $454.12 / $707.12	Professional	TC	$375.71	$454.12	$707.12