Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.17 / $89.17 / $182.43	Facility	26	$89.17	$89.17	$182.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $278.89 / $388.85 / $879.65	Professional		$278.89	$388.85	$879.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.69 / $89.17 / $225.06	Professional	26	$74.69	$89.17	$225.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.20 / $316.17 / $654.59	Professional	TC	$204.20	$316.17	$654.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $255.19 / $273.10 / $809.75	Professional		$255.19	$273.10	$809.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.11 / $117.76 / $302.45	Professional	26	$70.11	$117.76	$302.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $199.50 / $199.50 / $199.50	Professional	TC	$199.50	$199.50	$199.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $332.85 / $711.14 / $1,019.70	Professional		$332.85	$711.14	$1,019.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.54 / $195.58 / $276.58	Professional	26	$91.54	$195.58	$276.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $241.30 / $515.55 / $729.10	Professional	TC	$241.30	$515.55	$729.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $443.79 / $781.21 / $1,128.55	Professional		$443.79	$781.21	$1,128.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.14 / $191.67 / $280.94	Professional	26	$117.14	$191.67	$280.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $324.19 / $572.03 / $880.90	Professional	TC	$324.19	$572.03	$880.90
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $381.04 / $677.18 / $1,255.18	Professional		$381.04	$677.18	$1,255.18
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $104.79 / $186.23 / $345.19	Professional	26	$104.79	$186.23	$345.19
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $276.24 / $490.93 / $909.96	Professional	TC	$276.24	$490.93	$909.96
United Facility/Professional Professional Modifier Low / Median / High Price $463.13 / $519.65 / $973.47	Professional		$463.13	$519.65	$973.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.82 / $132.49 / $270.89	Professional	26	$104.82	$132.49	$270.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $334.97 / $373.86 / $701.12	Professional	TC	$334.97	$373.86	$701.12
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $294.55 / $369.87 / $554.80	Professional		$294.55	$369.87	$554.80
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $76.97 / $91.60 / $128.71	Professional	26	$76.97	$91.60	$128.71
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $217.58 / $261.10 / $412.10	Professional	TC	$217.58	$261.10	$412.10