Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.50 / $195.14 / $394.98	Facility	26	$127.50	$195.14	$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 $254.71 / $254.71 / $254.71	Professional		$254.71	$254.71	$254.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.41 / $97.01 / $189.18	Professional	26	$75.41	$97.01	$189.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.55 / $708.38 / $1,027.15	Professional		$331.55	$708.38	$1,027.15
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 $232.89 / $497.59 / $721.50	Professional	TC	$232.89	$497.59	$721.50
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 $458.73 / $797.06 / $1,832.94	Professional		$458.73	$797.06	$1,832.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.34 / $205.90 / $300.89	Professional	26	$124.34	$205.90	$300.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $325.38 / $582.76 / $1,573.05	Professional	TC	$325.38	$582.76	$1,573.05
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $379.56 / $674.55 / $1,250.31	Professional		$379.56	$674.55	$1,250.31
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 $266.62 / $473.84 / $878.27	Professional	TC	$266.62	$473.84	$878.27
United Facility/Professional Professional Modifier Low / Median / High Price $491.30 / $594.39 / $1,386.98	Professional		$491.30	$594.39	$1,386.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.35 / $143.65 / $323.37	Professional	26	$109.35	$143.65	$323.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $358.70 / $433.43 / $1,095.66	Professional	TC	$358.70	$433.43	$1,095.66
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $479.65 / $614.73 / $908.46	Professional		$479.65	$614.73	$908.46
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $81.55 / $97.75 / $132.22	Professional	26	$81.55	$97.75	$132.22
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $394.65 / $477.01 / $752.88	Professional	TC	$394.65	$477.01	$752.88