Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.40 / $334.32 / $334.32	Facility	26	$127.40	$334.32	$334.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.04 / $388.27 / $1,206.57	Professional		$240.04	$388.27	$1,206.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.83 / $82.66 / $231.40	Professional	26	$66.83	$82.66	$231.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.21 / $309.93 / $975.16	Professional	TC	$173.21	$309.93	$975.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $193.25 / $193.25 / $193.25	Professional	26	$193.25	$193.25	$193.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.74 / $640.65 / $906.00	Professional		$259.74	$640.65	$906.00
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 $177.91 / $465.80 / $658.73	Professional	TC	$177.91	$465.80	$658.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $399.73 / $714.27 / $1,184.71	Professional		$399.73	$714.27	$1,184.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.26 / $171.23 / $250.75	Professional	26	$104.26	$171.23	$250.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $292.88 / $530.22 / $964.22	Professional	TC	$292.88	$530.22	$964.22
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $343.27 / $610.05 / $1,130.77	Professional		$343.27	$610.05	$1,130.77
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $93.69 / $166.51 / $308.62	Professional	26	$93.69	$166.51	$308.62
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $249.58 / $438.34 / $822.14	Professional	TC	$249.58	$438.34	$822.14
United Facility/Professional Professional Modifier Low / Median / High Price $379.70 / $494.85 / $1,052.23	Professional		$379.70	$494.85	$1,052.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.78 / $118.32 / $242.50	Professional	26	$87.78	$118.32	$242.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.07 / $344.24 / $597.55	Professional	TC	$295.07	$344.24	$597.55
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $215.05 / $295.91 / $475.16	Professional		$215.05	$295.91	$475.16
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $68.77 / $82.68 / $110.71	Professional	26	$68.77	$82.68	$110.71
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $146.28 / $181.39 / $392.47	Professional	TC	$146.28	$181.39	$392.47