Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.65 / $127.50 / $245.68	Facility	26	$93.65	$127.50	$245.68
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 $89.01 / $127.50 / $245.68	Professional	26	$89.01	$127.50	$245.68
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 $226.14 / $240.01 / $240.01	Professional		$226.14	$240.01	$240.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.37 / $51.65 / $79.53	Professional	26	$49.37	$51.65	$79.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $296.29 / $633.04 / $895.25	Professional		$296.29	$633.04	$895.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.78 / $132.00 / $186.67	Professional	26	$61.78	$132.00	$186.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.51 / $501.05 / $708.58	Professional	TC	$234.51	$501.05	$708.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $411.06 / $715.74 / $1,240.13	Professional		$411.06	$715.74	$1,240.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.34 / $130.97 / $190.99	Professional	26	$77.34	$130.97	$190.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $327.18 / $579.54 / $1,048.59	Professional	TC	$327.18	$579.54	$1,048.59
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $339.19 / $602.80 / $1,117.33	Professional		$339.19	$602.80	$1,117.33
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $70.73 / $125.70 / $232.99	Professional	26	$70.73	$125.70	$232.99
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $268.47 / $477.12 / $884.37	Professional	TC	$268.47	$477.12	$884.37
United Facility/Professional Professional Modifier Low / Median / High Price $445.45 / $586.84 / $977.12	Professional		$445.45	$586.84	$977.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.56 / $89.64 / $184.11	Professional	26	$61.56	$89.64	$184.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $361.41 / $427.55 / $825.39	Professional	TC	$361.41	$427.55	$825.39
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $312.99 / $416.06 / $592.79	Professional		$312.99	$416.06	$592.79
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $51.69 / $61.95 / $83.81	Professional	26	$51.69	$61.95	$83.81
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $259.05 / $313.12 / $494.20	Professional	TC	$259.05	$313.12	$494.20