Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.85 / $354.25 / $354.25	Facility	26	$86.85	$354.25	$354.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $277.98 / $392.31 / $1,218.39	Professional		$277.98	$392.31	$1,218.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $86.86 / $243.22	Professional	26	$69.84	$86.86	$243.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.14 / $309.93 / $975.16	Professional	TC	$208.14	$309.93	$975.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.02 / $110.64 / $203.17	Professional	26	$69.02	$110.64	$203.17
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $387.36 / $387.36 / $387.36	Professional	50	$387.36	$387.36	$387.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.95 / $679.35 / $960.73	Professional		$263.95	$679.35	$960.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.04 / $183.83 / $259.97	Professional	26	$86.04	$183.83	$259.97
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $395.92 / $1,019.02 / $1,441.10	Professional	50	$395.92	$1,019.02	$1,441.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $177.91 / $495.52 / $700.76	Professional	TC	$177.91	$495.52	$700.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $423.89 / $757.75 / $1,238.57	Professional		$423.89	$757.75	$1,238.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.87 / $180.08 / $263.82	Professional	26	$108.87	$180.08	$263.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $311.52 / $563.59 / $1,006.57	Professional	TC	$311.52	$563.59	$1,006.57
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $364.00 / $646.90 / $1,199.05	Professional		$364.00	$646.90	$1,199.05
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $98.50 / $175.05 / $324.47	Professional	26	$98.50	$175.05	$324.47
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $265.51 / $471.86 / $874.62	Professional	TC	$265.51	$471.86	$874.62
United Facility/Professional Professional Modifier Low / Median / High Price $447.50 / $502.21 / $979.84	Professional		$447.50	$502.21	$979.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.89 / $123.92 / $253.06	Professional	26	$87.89	$123.92	$253.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $331.15 / $397.35 / $723.71	Professional	TC	$331.15	$397.35	$723.71
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $218.30 / $300.38 / $496.80	Professional		$218.30	$300.38	$496.80
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $72.03 / $87.08 / $115.96	Professional	26	$72.03	$87.08	$115.96
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $146.28 / $181.39 / $409.72	Professional	TC	$146.28	$181.39	$409.72