Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $183.46 / $496.69 / $496.69	Facility	26	$183.46	$496.69	$496.69
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 26 Low / Median / High Price $94.21 / $389.11 / $389.11	Professional	26	$94.21	$389.11	$389.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.84 / $758.14 / $1,087.08	Professional		$354.84	$758.14	$1,087.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.74 / $251.56 / $355.75	Professional	26	$117.74	$251.56	$355.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $237.10 / $506.58 / $726.38	Professional	TC	$237.10	$506.58	$726.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $487.77 / $856.86 / $1,502.08	Professional		$487.77	$856.86	$1,502.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $146.18 / $247.51 / $361.11	Professional	26	$146.18	$247.51	$361.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $330.79 / $589.23 / $1,168.40	Professional	TC	$330.79	$589.23	$1,168.40
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $406.22 / $721.93 / $1,338.13	Professional		$406.22	$721.93	$1,338.13
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $134.79 / $233.16 / $444.01	Professional	26	$134.79	$233.16	$444.01
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $271.43 / $482.39 / $894.12	Professional	TC	$271.43	$482.39	$894.12
United Facility/Professional Professional Modifier Low / Median / High Price $528.38 / $638.46 / $1,169.75	Professional		$528.38	$638.46	$1,169.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $126.34 / $169.36 / $346.34	Professional	26	$126.34	$169.36	$346.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $308.69 / $432.17 / $823.41	Professional	TC	$308.69	$432.17	$823.41
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $409.25 / $497.37 / $746.06	Professional		$409.25	$497.37	$746.06
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $97.84 / $121.32 / $159.41	Professional	26	$97.84	$121.32	$159.41
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $309.17 / $373.69 / $589.80	Professional	TC	$309.17	$373.69	$589.80