Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $131.83 / $269.15	Facility	26	$102.33	$131.83	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $426.58 / $954.99	Professional		$213.80	$426.58	$954.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $125.89 / $295.12	Professional	26	$70.79	$125.89	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $288.40 / $436.52	Professional	TC	$141.25	$288.40	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $147.91 / $151.36	Professional		$134.90	$147.91	$151.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $85.11 / $218.78	Professional	26	$53.70	$85.11	$218.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $151.36	Professional	TC	$151.36	$151.36	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $457.09 / $691.83	Professional		$194.98	$457.09	$691.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $154.88 / $223.87	Professional	26	$66.07	$154.88	$223.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $295.12 / $478.63	Professional	TC	$125.89	$295.12	$478.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $524.81 / $1,122.02	Professional		$269.15	$524.81	$1,122.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $144.54 / $213.80	Professional	26	$87.10	$144.54	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $371.54 / $891.25	Professional	TC	$177.83	$371.54	$891.25
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $346.74 / $549.54	Professional		$218.78	$346.74	$549.54
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $120.23 / $186.21	Professional	26	$77.62	$120.23	$186.21
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $229.09 / $346.74	Professional	TC	$147.91	$229.09	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $398.11 / $776.25	Professional		$229.09	$398.11	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $97.72 / $194.98	Professional	26	$66.07	$97.72	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $245.47 / $549.54	Professional	TC	$154.88	$245.47	$549.54
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $51.29 / $51.29	Facility	26	$43.65	$51.29	$51.29