Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.31 / $477.50 / $917.33	Facility		$76.31	$477.50	$917.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.00 / $39.84 / $96.38	Facility	26	$27.00	$39.84	$96.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.84 / $76.31 / $257.04	Professional		$67.84	$76.31	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.61 / $27.00 / $63.79	Professional	26	$20.61	$27.00	$63.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.04 / $49.33 / $167.01	Professional	TC	$44.04	$49.33	$167.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $71.81 / $71.81 / $71.81	Professional	26	$71.81	$71.81	$71.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $470.64 / $591.46 / $657.05	Facility		$470.64	$591.46	$657.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.30 / $158.63 / $223.30	Professional		$110.30	$158.63	$223.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $36.75 / $51.52	Professional	26	$25.55	$36.75	$51.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.75 / $121.88 / $171.03	Professional	TC	$84.75	$121.88	$171.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $445.90 / $445.90 / $445.90	Facility		$445.90	$445.90	$445.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.27 / $264.12 / $361.60	Professional		$147.27	$264.12	$361.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.69 / $59.05 / $80.78	Professional	26	$34.69	$59.05	$80.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.48 / $205.12 / $280.83	Professional	TC	$106.48	$205.12	$280.83
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $126.27 / $250.49 / $415.95	Professional		$126.27	$250.49	$415.95
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $29.25 / $55.73 / $96.35	Professional	26	$29.25	$55.73	$96.35
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $97.02 / $192.47 / $319.58	Professional	TC	$97.02	$192.47	$319.58
United Facility/Professional Professional Modifier Low / Median / High Price $90.95 / $189.64 / $499.35	Professional		$90.95	$189.64	$499.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.96 / $35.39 / $71.41	Professional	26	$27.96	$35.39	$71.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.38 / $128.49 / $372.83	Professional	TC	$82.38	$128.49	$372.83
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $67.39 / $99.92 / $153.27	Professional		$67.39	$99.92	$153.27
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $21.28 / $25.04 / $34.52	Professional	26	$21.28	$25.04	$34.52
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $43.14 / $75.28 / $105.38	Professional	TC	$43.14	$75.28	$105.38