Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.69 / $127.50 / $247.02	Facility	26	$92.69	$127.50	$247.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $1,320.50	Professional		$370.50	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.01 / $127.50 / $247.02	Professional	26	$89.01	$127.50	$247.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $712.50 / $712.50 / $712.50	Professional	50	$712.50	$712.50	$712.50
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 $177.92 / $177.92 / $179.68	Professional		$177.92	$177.92	$179.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.14 / $51.39 / $203.17	Professional	26	$47.14	$51.39	$203.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.99 / $467.87 / $678.41	Professional		$218.99	$467.87	$678.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.46 / $131.31 / $185.69	Professional	26	$61.46	$131.31	$185.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $328.48 / $701.80 / $1,006.31	Professional	50	$328.48	$701.80	$1,006.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $157.53 / $336.57 / $488.02	Professional	TC	$157.53	$336.57	$488.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.20 / $542.01 / $1,100.13	Professional		$303.20	$542.01	$1,100.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.34 / $130.58 / $188.93	Professional	26	$77.34	$130.58	$188.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.08 / $397.22 / $967.04	Professional	TC	$220.08	$397.22	$967.04
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $250.69 / $445.53 / $825.80	Professional		$250.69	$445.53	$825.80
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $70.36 / $121.71 / $231.77	Professional	26	$70.36	$121.71	$231.77
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $180.34 / $320.50 / $594.05	Professional	TC	$180.34	$320.50	$594.05
United Facility/Professional Professional Modifier Low / Median / High Price $324.52 / $396.87 / $1,007.54	Professional		$324.52	$396.87	$1,007.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.57 / $89.61 / $183.11	Professional	26	$61.57	$89.61	$183.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $240.94 / $421.14 / $815.56	Professional	TC	$240.94	$421.14	$815.56
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $290.63 / $399.91 / $550.45	Professional		$290.63	$399.91	$550.45
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $51.40 / $61.61 / $83.34	Professional	26	$51.40	$61.61	$83.34
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $238.86 / $286.63 / $452.40	Professional	TC	$238.86	$286.63	$452.40