Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.59 / $105.59 / $169.80	Facility	26	$105.59	$105.59	$169.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.20 / $349.96 / $699.77	Professional		$263.20	$349.96	$699.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.53 / $105.59 / $193.18	Professional	26	$87.53	$105.59	$193.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $175.68 / $244.38 / $433.22	Professional	TC	$175.68	$244.38	$433.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $87.34 / $257.37 / $360.15	Professional	26	$87.34	$257.37	$360.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $318.29 / $680.04 / $975.10	Professional		$318.29	$680.04	$975.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.01 / $232.90 / $329.36	Professional	26	$109.01	$232.90	$329.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $209.28 / $447.14 / $641.15	Professional	TC	$209.28	$447.14	$641.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.83 / $753.31 / $1,378.43	Professional		$436.83	$753.31	$1,378.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $135.88 / $227.61 / $334.01	Professional	26	$135.88	$227.61	$334.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $291.89 / $512.59 / $987.04	Professional	TC	$291.89	$512.59	$987.04
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $364.38 / $647.58 / $1,200.30	Professional		$364.38	$647.58	$1,200.30
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $124.79 / $221.78 / $411.07	Professional	26	$124.79	$221.78	$411.07
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $239.58 / $425.78 / $789.20	Professional	TC	$239.58	$425.78	$789.20
United Facility/Professional Professional Modifier Low / Median / High Price $452.46 / $548.39 / $1,145.20	Professional		$452.46	$548.39	$1,145.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.46 / $156.27 / $320.68	Professional	26	$116.46	$156.27	$320.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $305.88 / $342.57 / $827.97	Professional	TC	$305.88	$342.57	$827.97
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $237.07 / $326.20 / $575.62	Professional		$237.07	$326.20	$575.62
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $90.14 / $108.05 / $146.18	Professional	26	$90.14	$108.05	$146.18
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $146.28 / $181.39 / $471.46	Professional	TC	$146.28	$181.39	$471.46