Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.23 / $223.97 / $223.97	Facility	26	$86.23	$223.97	$223.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.78 / $343.39 / $1,070.21	Professional		$206.78	$343.39	$1,070.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.08 / $55.32 / $154.79	Professional	26	$45.08	$55.32	$154.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $161.69 / $290.93 / $915.42	Professional	TC	$161.69	$290.93	$915.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.81 / $199.81 / $199.81	Professional		$199.81	$199.81	$199.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.17 / $46.26 / $130.62	Professional	26	$44.17	$46.26	$130.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $233.22 / $526.62 / $744.74	Professional		$233.22	$526.62	$744.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.31 / $118.18 / $167.13	Professional	26	$55.31	$118.18	$167.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $177.91 / $408.44 / $577.61	Professional	TC	$177.91	$408.44	$577.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.27 / $72.27 / $72.27	Facility	26	$72.27	$72.27	$72.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $329.17 / $594.07 / $907.62	Professional		$329.17	$594.07	$907.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.54 / $116.51 / $169.96	Professional	26	$70.54	$116.51	$169.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $256.85 / $471.81 / $760.14	Professional	TC	$256.85	$471.81	$760.14
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $282.17 / $501.47 / $929.50	Professional		$282.17	$501.47	$929.50
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $63.32 / $112.53 / $208.58	Professional	26	$63.32	$112.53	$208.58
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $218.85 / $388.94 / $720.91	Professional	TC	$218.85	$388.94	$720.91
United Facility/Professional Professional Modifier Low / Median / High Price $343.25 / $400.46 / $712.76	Professional		$343.25	$400.46	$712.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.80 / $82.00 / $163.36	Professional	26	$55.80	$82.00	$163.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $267.55 / $321.02 / $552.28	Professional	TC	$267.55	$321.02	$552.28
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $193.15 / $265.77 / $365.83	Professional		$193.15	$265.77	$365.83
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $46.55 / $55.79 / $75.47	Professional	26	$46.55	$55.79	$75.47
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $146.28 / $180.26 / $309.37	Professional	TC	$146.28	$180.26	$309.37