Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.40 / $497.35 / $1,249.94	Facility		$111.40	$497.35	$1,249.94
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.34 / $56.75 / $147.91	Facility	26	$39.34	$56.75	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.36 / $136.33 / $378.99	Professional		$97.36	$136.33	$378.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.97 / $39.34 / $102.22	Professional	26	$29.97	$39.34	$102.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.39 / $98.43 / $276.80	Professional	TC	$67.39	$98.43	$276.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.24 / $119.15 / $271.76	Professional		$86.24	$119.15	$271.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.95 / $30.83 / $87.06	Professional	26	$27.95	$30.83	$87.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $475.38 / $597.41 / $663.67	Facility		$475.38	$597.41	$663.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.92 / $164.32 / $230.39	Professional		$111.92	$164.32	$230.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.88 / $54.14 / $75.90	Professional	26	$36.88	$54.14	$75.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.04 / $110.18 / $154.47	Professional	TC	$75.04	$110.18	$154.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $370.06 / $628.33 / $682.90	Facility		$370.06	$628.33	$682.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.91 / $224.63 / $361.67	Professional		$143.91	$224.63	$361.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.92 / $71.68 / $113.36	Professional	26	$45.92	$71.68	$113.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.18 / $151.50 / $246.49	Professional	TC	$98.18	$151.50	$246.49
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $125.90 / $211.53 / $395.44	Professional		$125.90	$211.53	$395.44
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $42.21 / $73.01 / $130.28	Professional	26	$42.21	$73.01	$130.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $89.53 / $153.71 / $283.00	Professional	TC	$89.53	$153.71	$283.00
United Facility/Professional Professional Modifier Low / Median / High Price $136.86 / $165.89 / $278.88	Professional		$136.86	$165.89	$278.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.57 / $50.75 / $108.60	Professional	26	$41.57	$50.75	$108.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.50 / $107.87 / $212.40	Professional	TC	$94.50	$107.87	$212.40
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $98.31 / $117.97 / $173.42	Professional		$98.31	$117.97	$173.42
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $31.19 / $37.36 / $50.57	Professional	26	$31.19	$37.36	$50.57
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $66.91 / $79.62 / $116.72	Professional	TC	$66.91	$79.62	$116.72