Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.50 / $157.50 / $414.84	Facility	26	$127.50	$157.50	$414.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $475.00 / $1,320.50	Professional		$400.00	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.59 / $140.00 / $389.19	Professional	26	$118.59	$140.00	$389.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $931.29	Professional	TC	$281.41	$335.00	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $255.52 / $272.60 / $808.26	Professional		$255.52	$272.60	$808.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.94 / $98.94 / $332.27	Professional	26	$76.94	$98.94	$332.27
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $191.74 / $191.74 / $191.74	Professional	TC	$191.74	$191.74	$191.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $332.52 / $710.45 / $1,030.15	Professional		$332.52	$710.45	$1,030.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.60 / $214.93 / $303.95	Professional	26	$100.60	$214.93	$303.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $231.92 / $495.52 / $718.50	Professional	TC	$231.92	$495.52	$718.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $460.01 / $820.98 / $1,840.68	Professional		$460.01	$820.98	$1,840.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.66 / $211.92 / $307.94	Professional	26	$128.66	$211.92	$307.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $324.02 / $584.26 / $1,504.62	Professional	TC	$324.02	$584.26	$1,504.62
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $380.67 / $676.53 / $1,253.96	Professional		$380.67	$676.53	$1,253.96
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $115.16 / $204.22 / $379.35	Professional	26	$115.16	$204.22	$379.35
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $265.51 / $471.86 / $874.62	Professional	TC	$265.51	$471.86	$874.62
United Facility/Professional Professional Modifier Low / Median / High Price $492.56 / $615.71 / $1,398.18	Professional		$492.56	$615.71	$1,398.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $103.21 / $144.68 / $306.47	Professional	26	$103.21	$144.68	$306.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $297.42 / $407.78 / $1,091.71	Professional	TC	$297.42	$407.78	$1,091.71
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $409.75 / $563.82 / $776.07	Professional		$409.75	$563.82	$776.07
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $84.04 / $102.20 / $135.29	Professional	26	$84.04	$102.20	$135.29
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $325.70 / $390.85 / $638.16	Professional	TC	$325.70	$390.85	$638.16