Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.67 / $680.52 / $1,031.76	Facility		$125.67	$680.52	$1,031.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.93 / $47.15 / $123.53	Facility	26	$32.93	$47.15	$123.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.35 / $179.53 / $559.29	Professional		$46.35	$179.53	$559.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.37 / $32.94 / $93.19	Professional	26	$24.37	$32.94	$93.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.99 / $150.53 / $465.06	Professional	TC	$21.99	$150.53	$465.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.64 / $46.63 / $138.26	Professional		$39.64	$46.63	$138.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.34 / $37.42 / $96.09	Professional	26	$23.34	$37.42	$96.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $241.39 / $303.36 / $337.00	Facility		$241.39	$303.36	$337.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.25 / $62.86 / $108.41	Professional		$57.25	$62.86	$108.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.11 / $31.96 / $53.24	Professional	26	$29.11	$31.96	$53.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.14 / $30.15 / $53.29	Professional	TC	$28.14	$30.15	$53.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $940.92 / $940.92 / $940.92	Facility		$940.92	$940.92	$940.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.77 / $130.01 / $265.83	Professional		$75.77	$130.01	$265.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.11 / $57.72 / $90.11	Professional	26	$37.11	$57.72	$90.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.77 / $63.75 / $198.69	Professional	TC	$37.77	$63.75	$198.69
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $50.69 / $103.11 / $202.29	Professional		$50.69	$103.11	$202.29
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $33.33 / $58.54 / $109.79	Professional	26	$33.33	$58.54	$109.79
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $32.22 / $61.39 / $106.14	Professional	TC	$32.22	$61.39	$106.14
United Facility/Professional Professional Modifier Low / Median / High Price $71.78 / $99.69 / $191.22	Professional		$71.78	$99.69	$191.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.61 / $39.32 / $80.66	Professional	26	$32.61	$39.32	$80.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.46 / $39.22 / $151.79	Professional	TC	$32.46	$39.22	$151.79
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $45.13 / $60.93 / $180.59	Professional		$45.13	$60.93	$180.59
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $24.31 / $29.17 / $37.97	Professional	26	$24.31	$29.17	$37.97
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $20.82 / $24.98 / $150.22	Professional	TC	$20.82	$24.98	$150.22