Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.90 / $331.64 / $331.64	Facility	26	$126.90	$331.64	$331.64
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 $118.36 / $127.50 / $331.64	Professional	26	$118.36	$127.50	$331.64
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 26 Low / Median / High Price $65.45 / $269.14 / $269.14	Professional	26	$65.45	$269.14	$269.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.55 / $708.38 / $1,015.74	Professional		$331.55	$708.38	$1,015.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.51 / $174.16 / $246.29	Professional	26	$81.51	$174.16	$246.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $250.04 / $534.22 / $766.01	Professional	TC	$250.04	$534.22	$766.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.60 / $63.60 / $63.60	Facility	26	$63.60	$63.60	$63.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $459.31 / $792.69 / $1,433.18	Professional		$459.31	$792.69	$1,433.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.12 / $172.65 / $249.89	Professional	26	$104.12	$172.65	$249.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $348.79 / $609.20 / $1,108.89	Professional	TC	$348.79	$609.20	$1,108.89
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $379.56 / $674.55 / $1,250.31	Professional		$379.56	$674.55	$1,250.31
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $93.32 / $165.85 / $307.41	Professional	26	$93.32	$165.85	$307.41
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $286.24 / $507.62 / $942.90	Professional	TC	$286.24	$507.62	$942.90
United Facility/Professional Professional Modifier Low / Median / High Price $414.33 / $549.79 / $1,112.66	Professional		$414.33	$549.79	$1,112.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.17 / $118.70 / $241.89	Professional	26	$82.17	$118.70	$241.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $378.08 / $453.64 / $870.77	Professional	TC	$378.08	$453.64	$870.77
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $373.61 / $480.27 / $707.62	Professional		$373.61	$480.27	$707.62
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $68.01 / $81.54 / $110.28	Professional	26	$68.01	$81.54	$110.28
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $302.91 / $366.13 / $577.88	Professional	TC	$302.91	$366.13	$577.88