Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $194.98 / $398.11	Facility	26	$128.82	$194.98	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $426.58 / $1,230.27	Professional		$199.53	$426.58	$1,230.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $169.82 / $416.87	Professional	26	$104.71	$169.82	$416.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $363.08 / $912.01	Professional	TC	$281.84	$363.08	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $309.03	Professional		$269.15	$269.15	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $125.89 / $128.82	Professional	26	$79.43	$125.89	$128.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $891.25 / $1,288.25	Professional		$380.19	$891.25	$1,288.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $229.09 / $331.13	Professional	26	$100.00	$229.09	$331.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $660.69 / $977.24	Professional	TC	$281.84	$660.69	$977.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $912.01 / $1,778.28	Professional		$524.81	$912.01	$1,778.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $204.17 / $309.03	Professional	26	$125.89	$204.17	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $676.08 / $1,621.81	Professional	TC	$389.05	$676.08	$1,621.81
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $691.83 / $1,096.48	Professional		$446.68	$691.83	$1,096.48
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $177.83 / $275.42	Professional	26	$114.82	$177.83	$275.42
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $512.86 / $794.33	Professional	TC	$331.13	$512.86	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $776.25 / $1,318.26	Professional		$457.09	$776.25	$1,318.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $144.54 / $288.40	Professional	26	$97.72	$144.54	$288.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $549.54 / $1,023.29	Professional	TC	$338.84	$549.54	$1,023.29
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $75.86 / $75.86	Facility	26	$64.57	$75.86	$75.86