Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $194.98 / $398.11	Facility	26	$128.82	$194.98	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $478.63 / $1,318.26	Professional		$234.42	$478.63	$1,318.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $181.97 / $338.84	Professional	26	$107.15	$181.97	$338.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $398.11 / $933.25	Professional	TC	$281.84	$398.11	$933.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $125.89 / $331.13	Professional	26	$79.43	$125.89	$331.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $257.04 / $257.04	Professional	TC	$257.04	$257.04	$257.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $954.99 / $1,380.38	Professional		$407.38	$954.99	$1,380.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $229.09 / $331.13	Professional	26	$100.00	$229.09	$331.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $707.95 / $1,047.13	Professional	TC	$309.03	$707.95	$1,047.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $977.24 / $1,905.46	Professional		$562.34	$977.24	$1,905.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $204.17 / $309.03	Professional	26	$125.89	$204.17	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $741.31 / $1,698.24	Professional	TC	$426.58	$741.31	$1,698.24
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $741.31 / $1,148.15	Professional		$478.63	$741.31	$1,148.15
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $177.83 / $263.03	Professional	26	$114.82	$177.83	$263.03
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $562.34 / $870.96	Professional	TC	$363.08	$562.34	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $794.33 / $1,380.38	Professional		$478.63	$794.33	$1,380.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $144.54 / $288.40	Professional	26	$97.72	$144.54	$288.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $588.84 / $1,071.52	Professional	TC	$371.54	$588.84	$1,071.52
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $75.86 / $75.86	Facility	26	$64.57	$75.86	$75.86