Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.41 / $331.64 / $331.64	Facility	26	$127.41	$331.64	$331.64
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 $118.36 / $127.50 / $331.64	Professional	26	$118.36	$127.50	$331.64
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 26 Low / Median / High Price $270.23 / $270.23 / $270.23	Professional	26	$270.23	$270.23	$270.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $333.17 / $711.83 / $1,020.69	Professional		$333.17	$711.83	$1,020.69
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 $251.33 / $536.98 / $769.97	Professional	TC	$251.33	$536.98	$769.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.60 / $63.60 / $63.60	Facility	26	$63.60	$63.60	$63.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $461.57 / $795.77 / $1,437.68	Professional		$461.57	$795.77	$1,437.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.58 / $171.26 / $249.89	Professional	26	$104.58	$171.26	$249.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $350.60 / $610.72 / $1,114.51	Professional	TC	$350.60	$610.72	$1,114.51
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $381.41 / $677.84 / $1,256.40	Professional		$381.41	$677.84	$1,256.40
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 $287.72 / $511.34 / $947.78	Professional	TC	$287.72	$511.34	$947.78
United Facility/Professional Professional Modifier Low / Median / High Price $486.49 / $547.21 / $1,107.75	Professional		$486.49	$547.21	$1,107.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.16 / $114.08 / $240.58	Professional	26	$82.16	$114.08	$240.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $318.26 / $454.66 / $881.95	Professional	TC	$318.26	$454.66	$881.95
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $371.26 / $481.80 / $703.17	Professional		$371.26	$481.80	$703.17
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $67.95 / $81.54 / $109.81	Professional	26	$67.95	$81.54	$109.81
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $300.87 / $363.66 / $573.98	Professional	TC	$300.87	$363.66	$573.98