Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.45 / $96.45 / $198.88	Facility	26	$96.45	$96.45	$198.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $307.20 / $512.36 / $973.29	Professional		$307.20	$512.36	$973.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.31 / $96.45 / $244.84	Professional	26	$81.31	$96.45	$244.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $225.90 / $421.11 / $728.42	Professional	TC	$225.90	$421.11	$728.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $910.40 / $910.40 / $910.40	Professional		$910.40	$910.40	$910.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.93 / $124.96 / $331.02	Professional	26	$76.93	$124.96	$331.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $374.25 / $799.60 / $1,146.54	Professional		$374.25	$799.60	$1,146.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.27 / $214.24 / $302.97	Professional	26	$100.27	$214.24	$302.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $273.97 / $585.36 / $827.81	Professional	TC	$273.97	$585.36	$827.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $498.95 / $892.83 / $1,473.88	Professional		$498.95	$892.83	$1,473.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.08 / $209.18 / $306.77	Professional	26	$128.08	$209.18	$306.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $368.05 / $666.20 / $1,208.95	Professional	TC	$368.05	$666.20	$1,208.95
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $428.44 / $761.42 / $1,411.32	Professional		$428.44	$761.42	$1,411.32
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $114.79 / $204.00 / $378.13	Professional	26	$114.79	$204.00	$378.13
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $313.64 / $557.40 / $1,033.16	Professional	TC	$313.64	$557.40	$1,033.16
United Facility/Professional Professional Modifier Low / Median / High Price $473.91 / $617.42 / $1,313.30	Professional		$473.91	$617.42	$1,313.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $111.80 / $146.91 / $652.69	Professional	26	$111.80	$146.91	$652.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $374.47 / $452.49 / $758.76	Professional	TC	$374.47	$452.49	$758.76
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $324.38 / $437.91 / $614.38	Professional		$324.38	$437.91	$614.38
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $83.34 / $98.05 / $139.63	Professional	26	$83.34	$98.05	$139.63
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $240.43 / $288.52 / $455.37	Professional	TC	$240.43	$288.52	$455.37