Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.50 / $234.43 / $394.98	Facility	26	$127.50	$234.43	$394.98
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 $330.14 / $978.85 / $978.85	Professional		$330.14	$978.85	$978.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.29 / $126.87 / $325.86	Professional	26	$79.29	$126.87	$325.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $402.07 / $859.04 / $1,214.84	Professional		$402.07	$859.04	$1,214.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $98.66 / $210.79 / $298.08	Professional	26	$98.66	$210.79	$298.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $303.41 / $648.25 / $916.75	Professional	TC	$303.41	$648.25	$916.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.04 / $100.04 / $100.04	Facility	26	$100.04	$100.04	$100.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $557.10 / $965.41 / $1,832.94	Professional		$557.10	$965.41	$1,832.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.34 / $207.85 / $301.93	Professional	26	$124.34	$207.85	$301.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $423.29 / $748.58 / $1,573.05	Professional	TC	$423.29	$748.58	$1,573.05
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $460.28 / $818.01 / $1,516.21	Professional		$460.28	$818.01	$1,516.21
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $112.94 / $200.72 / $372.04	Professional	26	$112.94	$200.72	$372.04
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $347.34 / $617.29 / $1,144.17	Professional	TC	$347.34	$617.29	$1,144.17
United Facility/Professional Professional Modifier Low / Median / High Price $604.09 / $729.74 / $1,380.08	Professional		$604.09	$729.74	$1,380.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $90.88 / $141.90 / $291.32	Professional	26	$90.88	$141.90	$291.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $414.46 / $569.17 / $1,088.76	Professional	TC	$414.46	$569.17	$1,088.76
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $507.37 / $614.73 / $922.10	Professional		$507.37	$614.73	$922.10
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $81.84 / $98.10 / $132.69	Professional	26	$81.84	$98.10	$132.69
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $421.88 / $509.93 / $800.46	Professional	TC	$421.88	$509.93	$800.46