Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.48 / $318.39 / $318.39	Facility	26	$122.48	$318.39	$318.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $600.00	Professional		$370.50	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $127.50 / $140.00	Professional	26	$111.15	$127.50	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $480.00	Professional	TC	$259.35	$335.00	$480.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.89 / $62.89 / $62.89	Professional	26	$62.89	$62.89	$62.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.27 / $564.63 / $818.71	Professional		$264.27	$564.63	$818.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.59 / $167.94 / $237.50	Professional	26	$78.59	$167.94	$237.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $185.67 / $396.69 / $575.20	Professional	TC	$185.67	$396.69	$575.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.44 / $108.44 / $108.44	Facility	26	$108.44	$108.44	$108.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.67 / $651.55 / $1,301.80	Professional		$365.67	$651.55	$1,301.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.24 / $167.71 / $241.90	Professional	26	$99.24	$167.71	$241.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $259.36 / $465.15 / $1,107.56	Professional	TC	$259.36	$465.15	$1,107.56
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $302.54 / $537.66 / $996.60	Professional		$302.54	$537.66	$996.60
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $89.98 / $150.78 / $296.39	Professional	26	$89.98	$150.78	$296.39
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $212.55 / $377.74 / $700.16	Professional	TC	$212.55	$377.74	$700.16
United Facility/Professional Professional Modifier Low / Median / High Price $334.64 / $503.39 / $1,133.72	Professional		$334.64	$503.39	$1,133.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.25 / $115.42 / $235.33	Professional	26	$79.25	$115.42	$235.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $283.33 / $342.37 / $898.39	Professional	TC	$283.33	$342.37	$898.39
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $442.99 / $531.59 / $781.43	Professional		$442.99	$531.59	$781.43
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $66.17 / $79.31 / $107.30	Professional	26	$66.17	$79.31	$107.30
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $373.63 / $447.85 / $605.87	Professional	TC	$373.63	$447.85	$605.87