Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.50 / $233.63 / $394.98	Facility	26	$127.50	$233.63	$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 $918.65 / $918.65 / $918.65	Professional		$918.65	$918.65	$918.65
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 $377.48 / $806.51 / $1,140.56	Professional		$377.48	$806.51	$1,140.56
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 $278.83 / $595.73 / $854.21	Professional	TC	$278.83	$595.73	$854.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $522.67 / $914.87 / $1,743.72	Professional		$522.67	$914.87	$1,743.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.61 / $207.26 / $301.93	Professional	26	$123.61	$207.26	$301.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $389.04 / $690.76 / $1,483.83	Professional	TC	$389.04	$690.76	$1,483.83
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $432.14 / $768.00 / $1,423.51	Professional		$432.14	$768.00	$1,423.51
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 $319.20 / $567.28 / $1,051.48	Professional	TC	$319.20	$567.28	$1,051.48
United Facility/Professional Professional Modifier Low / Median / High Price $568.91 / $687.51 / $1,440.99	Professional		$568.91	$687.51	$1,440.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.49 / $142.62 / $291.32	Professional	26	$98.49	$142.62	$291.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $435.88 / $526.67 / $1,017.73	Professional	TC	$435.88	$526.67	$1,017.73
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $496.39 / $595.66 / $876.42	Professional		$496.39	$595.66	$876.42
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 $410.98 / $496.75 / $754.79	Professional	TC	$410.98	$496.75	$754.79