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 / $393.64	Facility	26	$127.50	$234.43	$393.64
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 $118.59 / $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 26 Low / Median / High Price $79.16 / $126.87 / $232.83	Professional	26	$79.16	$126.87	$232.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $378.45 / $808.59 / $1,143.50	Professional		$378.45	$808.59	$1,143.50
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 $279.80 / $597.79 / $857.18	Professional	TC	$279.80	$597.79	$857.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.05 / $917.91 / $1,747.32	Professional		$524.05	$917.91	$1,747.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.61 / $207.91 / $302.95	Professional	26	$123.61	$207.91	$302.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $390.39 / $693.04 / $1,488.33	Professional	TC	$390.39	$693.04	$1,488.33
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $433.25 / $769.97 / $1,427.17	Professional		$433.25	$769.97	$1,427.17
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 $320.31 / $569.25 / $1,055.13	Professional	TC	$320.31	$569.25	$1,055.13
United Facility/Professional Professional Modifier Low / Median / High Price $569.82 / $733.64 / $1,328.04	Professional		$569.82	$733.64	$1,328.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.50 / $142.62 / $324.47	Professional	26	$98.50	$142.62	$324.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $436.78 / $524.02 / $1,018.16	Professional	TC	$436.78	$524.02	$1,018.16
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $496.52 / $595.82 / $878.25	Professional		$496.52	$595.82	$878.25
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 $411.11 / $496.91 / $757.08	Professional	TC	$411.11	$496.91	$757.08