Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.31 / $159.26 / $268.22	Facility	26	$103.31	$159.26	$268.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $374.29 / $472.96 / $1,320.50	Professional		$374.29	$472.96	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.36 / $127.50 / $268.22	Professional	26	$96.36	$127.50	$268.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $931.29	Professional	TC	$259.35	$335.00	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $467.28 / $467.28 / $467.28	Professional		$467.28	$467.28	$467.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.82 / $85.31 / $219.11	Professional	26	$50.82	$85.31	$219.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $192.46 / $411.20 / $596.24	Professional		$192.46	$411.20	$596.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.31 / $141.68 / $200.36	Professional	26	$66.31	$141.68	$200.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $126.15 / $269.52 / $390.81	Professional	TC	$126.15	$269.52	$390.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.44 / $108.44 / $108.44	Facility	26	$108.44	$108.44	$108.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.95 / $473.69 / $1,077.78	Professional		$265.95	$473.69	$1,077.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.41 / $141.36 / $204.88	Professional	26	$84.41	$141.36	$204.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $176.22 / $316.80 / $883.15	Professional	TC	$176.22	$316.80	$883.15
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $220.33 / $369.21 / $725.79	Professional		$220.33	$369.21	$725.79
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $75.91 / $133.32 / $250.06	Professional	26	$75.91	$133.32	$250.06
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $144.47 / $256.66 / $475.73	Professional	TC	$144.47	$256.66	$475.73
United Facility/Professional Professional Modifier Low / Median / High Price $283.22 / $343.22 / $918.22	Professional		$283.22	$343.22	$918.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.28 / $94.20 / $197.38	Professional	26	$66.28	$94.20	$197.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.21 / $230.61 / $720.84	Professional	TC	$192.21	$230.61	$720.84
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $284.10 / $373.88 / $538.09	Professional		$284.10	$373.88	$538.09
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $55.94 / $67.04 / $90.70	Professional	26	$55.94	$67.04	$90.70
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $227.76 / $273.31 / $431.38	Professional	TC	$227.76	$273.31	$431.38