Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.48 / $178.64 / $296.57	Facility	26	$115.48	$178.64	$296.57
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 $107.82 / $127.50 / $296.57	Professional	26	$107.82	$127.50	$296.57
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 $251.08 / $251.08 / $251.08	Professional		$251.08	$251.08	$251.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.17 / $86.42 / $142.07	Professional	26	$59.17	$86.42	$142.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $305.67 / $653.09 / $923.59	Professional		$305.67	$653.09	$923.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.06 / $158.26 / $223.81	Professional	26	$74.06	$158.26	$223.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $231.60 / $494.83 / $707.93	Professional	TC	$231.60	$494.83	$707.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $423.69 / $738.01 / $1,291.39	Professional		$423.69	$738.01	$1,291.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.90 / $157.38 / $229.03	Professional	26	$92.90	$157.38	$229.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.11 / $572.49 / $1,095.40	Professional	TC	$323.11	$572.49	$1,095.40
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $349.93 / $605.30 / $1,152.70	Professional		$349.93	$605.30	$1,152.70
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $84.80 / $139.79 / $279.33	Professional	26	$84.80	$139.79	$279.33
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $265.13 / $471.19 / $873.36	Professional	TC	$265.13	$471.19	$873.36
United Facility/Professional Professional Modifier Low / Median / High Price $461.12 / $557.04 / $1,043.61	Professional		$461.12	$557.04	$1,043.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.27 / $108.85 / $220.19	Professional	26	$74.27	$108.85	$220.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $359.60 / $434.52 / $823.43	Professional	TC	$359.60	$434.52	$823.43
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $507.99 / $679.95 / $1,042.98	Professional		$507.99	$679.95	$1,042.98
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $62.41 / $74.80 / $101.20	Professional	26	$62.41	$74.80	$101.20
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $445.78 / $607.66 / $850.67	Professional	TC	$445.78	$607.66	$850.67