Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.50 / $208.49 / $432.01	Facility	26	$127.50	$208.49	$432.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $384.35 / $475.00 / $1,320.50	Professional		$384.35	$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 $255.96 / $763.50 / $763.50	Professional		$255.96	$763.50	$763.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.33 / $135.18 / $347.19	Professional	26	$80.33	$135.18	$347.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $314.41 / $671.75 / $963.22	Professional		$314.41	$671.75	$963.22
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 $209.28 / $447.14 / $641.15	Professional	TC	$209.28	$447.14	$641.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.34 / $142.34 / $142.34	Facility	26	$142.34	$142.34	$142.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $431.96 / $751.75 / $1,757.70	Professional		$431.96	$751.75	$1,757.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.44 / $221.44 / $321.89	Professional	26	$134.44	$221.44	$321.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $291.95 / $514.66 / $1,486.53	Professional	TC	$291.95	$514.66	$1,486.53
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $359.93 / $639.66 / $1,185.65	Professional		$359.93	$639.66	$1,185.65
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $120.35 / $208.18 / $396.44	Professional	26	$120.35	$208.18	$396.44
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $239.58 / $425.78 / $789.20	Professional	TC	$239.58	$425.78	$789.20
United Facility/Professional Professional Modifier Low / Median / High Price $461.66 / $559.22 / $1,291.31	Professional		$461.66	$559.22	$1,291.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.58 / $152.47 / $311.25	Professional	26	$107.58	$152.47	$311.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $319.44 / $443.63 / $960.14	Professional	TC	$319.44	$443.63	$960.14
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $465.86 / $593.17 / $882.34	Professional		$465.86	$593.17	$882.34
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $88.08 / $106.88 / $141.80	Professional	26	$88.08	$106.88	$141.80
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $375.06 / $453.34 / $715.52	Professional	TC	$375.06	$453.34	$715.52