Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.62 / $80.62 / $165.26	Facility	26	$80.62	$80.62	$165.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.11 / $319.82 / $785.63	Professional		$246.11	$319.82	$785.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.81 / $80.62 / $205.06	Professional	26	$67.81	$80.62	$205.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $178.29 / $239.19 / $580.55	Professional	TC	$178.29	$239.19	$580.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $228.01 / $243.87 / $723.08	Professional		$228.01	$243.87	$723.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.81 / $69.76 / $275.66	Professional	26	$63.81	$69.76	$275.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $297.26 / $635.12 / $910.69	Professional		$297.26	$635.12	$910.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.45 / $178.30 / $252.15	Professional	26	$83.45	$178.30	$252.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $213.81 / $456.82 / $646.03	Professional	TC	$213.81	$456.82	$646.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $396.29 / $658.64 / $953.25	Professional		$396.29	$658.64	$953.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.76 / $174.70 / $254.97	Professional	26	$106.76	$174.70	$254.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $287.29 / $483.95 / $698.28	Professional	TC	$287.29	$483.95	$698.28
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $340.31 / $604.79 / $1,121.02	Professional		$340.31	$604.79	$1,121.02
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $95.54 / $169.79 / $314.72	Professional	26	$95.54	$169.79	$314.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $244.77 / $434.08 / $806.30	Professional	TC	$244.77	$434.08	$806.30
United Facility/Professional Professional Modifier Low / Median / High Price $375.02 / $446.37 / $851.97	Professional		$375.02	$446.37	$851.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $90.37 / $121.51 / $246.22	Professional	26	$90.37	$121.51	$246.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.95 / $339.90 / $750.29	Professional	TC	$263.95	$339.90	$750.29
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $261.97 / $314.36 / $462.12	Professional		$261.97	$314.36	$462.12
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $69.68 / $83.53 / $116.59	Professional	26	$69.68	$83.53	$116.59
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $191.78 / $228.22 / $332.04	Professional	TC	$191.78	$228.22	$332.04