Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.48 / $318.39 / $318.39	Facility	26	$122.48	$318.39	$318.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $648.51	Professional		$370.50	$475.00	$648.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $127.50 / $140.00	Professional	26	$111.15	$127.50	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $275.89 / $335.00 / $533.85	Professional	TC	$275.89	$335.00	$533.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $723.41 / $723.41 / $723.41	Professional		$723.41	$723.41	$723.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.89 / $65.73 / $65.73	Professional	26	$62.89	$65.73	$65.73
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 $78.59 / $167.94 / $237.50	Professional	26	$78.59	$167.94	$237.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $218.66 / $467.18 / $677.41	Professional	TC	$218.66	$467.18	$677.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $411.73 / $716.17 / $1,337.88	Professional		$411.73	$716.17	$1,337.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.15 / $167.30 / $241.90	Professional	26	$99.15	$167.30	$241.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $305.48 / $542.89 / $1,166.45	Professional	TC	$305.48	$542.89	$1,166.45
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $340.31 / $588.66 / $1,121.02	Professional		$340.31	$588.66	$1,121.02
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $89.98 / $148.33 / $296.39	Professional	26	$89.98	$148.33	$296.39
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $250.32 / $444.87 / $824.58	Professional	TC	$250.32	$444.87	$824.58
United Facility/Professional Professional Modifier Low / Median / High Price $393.02 / $535.94 / $1,256.04	Professional		$393.02	$535.94	$1,256.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.98 / $116.61 / $233.04	Professional	26	$84.98	$116.61	$233.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $279.74 / $406.17 / $985.41	Professional	TC	$279.74	$406.17	$985.41
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $371.04 / $501.18 / $702.75	Professional		$371.04	$501.18	$702.75
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $66.17 / $79.31 / $107.30	Professional	26	$66.17	$79.31	$107.30
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $304.39 / $365.27 / $576.51	Professional	TC	$304.39	$365.27	$576.51