Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.50 / $157.50 / $414.84	Facility	26	$127.50	$157.50	$414.84
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 $178.18 / $271.52 / $805.08	Professional		$178.18	$271.52	$805.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.94 / $129.37 / $332.27	Professional	26	$76.94	$129.37	$332.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.23 / $707.69 / $1,026.15	Professional		$331.23	$707.69	$1,026.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.60 / $214.93 / $303.95	Professional	26	$100.60	$214.93	$303.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $230.63 / $492.75 / $714.48	Professional	TC	$230.63	$492.75	$714.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $458.20 / $817.86 / $1,837.98	Professional		$458.20	$817.86	$1,837.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.66 / $211.92 / $307.94	Professional	26	$128.66	$211.92	$307.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $322.20 / $582.30 / $1,564.94	Professional	TC	$322.20	$582.30	$1,564.94
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $379.19 / $673.90 / $1,249.08	Professional		$379.19	$673.90	$1,249.08
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $115.16 / $204.66 / $379.35	Professional	26	$115.16	$204.66	$379.35
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $264.02 / $469.22 / $869.71	Professional	TC	$264.02	$469.22	$869.71
United Facility/Professional Professional Modifier Low / Median / High Price $491.66 / $633.02 / $1,548.69	Professional		$491.66	$633.02	$1,548.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $103.21 / $145.44 / $305.60	Professional	26	$103.21	$145.44	$305.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $313.20 / $427.11 / $1,082.02	Professional	TC	$313.20	$427.11	$1,082.02
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $480.76 / $616.05 / $910.56	Professional		$480.76	$616.05	$910.56
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $84.04 / $102.20 / $135.29	Professional	26	$84.04	$102.20	$135.29
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $393.86 / $476.06 / $751.39	Professional	TC	$393.86	$476.06	$751.39