Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $316.23 / $316.23 / $316.23	Facility	26	$316.23	$316.23	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $436.52 / $831.76	Professional		$316.23	$436.52	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $125.89 / $194.98	Professional	26	$85.11	$125.89	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $331.13 / $676.08	Professional	TC	$245.47	$331.13	$676.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $102.33 / $102.33	Professional	26	$102.33	$102.33	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $707.95 / $1,023.29	Professional		$302.00	$707.95	$1,023.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $181.97 / $263.03	Professional	26	$79.43	$181.97	$263.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $512.86 / $758.58	Professional	TC	$218.78	$512.86	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $707.95 / $1,513.56	Professional		$416.87	$707.95	$1,513.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $169.82 / $251.19	Professional	26	$102.33	$169.82	$251.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $549.54 / $1,288.25	Professional	TC	$309.03	$549.54	$1,288.25
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $575.44 / $851.14	Professional		$354.81	$575.44	$851.14
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $144.54 / $218.78	Professional	26	$91.20	$144.54	$218.78
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $407.38 / $630.96	Professional	TC	$257.04	$407.38	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $575.44 / $1,148.15	Professional		$354.81	$575.44	$1,148.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $117.49 / $234.42	Professional	26	$79.43	$117.49	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $407.38 / $812.83	Professional	TC	$269.15	$407.38	$812.83
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $61.66 / $61.66	Facility	26	$51.29	$61.66	$61.66