Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.45 / $127.50 / $127.50	Facility	26	$113.45	$127.50	$127.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $341.40 / $425.00 / $475.00	Professional		$341.40	$425.00	$475.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.10 / $127.50 / $140.00	Professional	26	$110.10	$127.50	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $227.97 / $297.50 / $335.00	Professional	TC	$227.97	$297.50	$335.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.17 / $58.17 / $58.17	Professional	26	$58.17	$58.17	$58.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.10 / $459.58 / $658.99	Professional		$215.10	$459.58	$658.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.78 / $155.50 / $219.90	Professional	26	$72.78	$155.50	$219.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $142.32 / $304.08 / $436.02	Professional	TC	$142.32	$304.08	$436.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.33 / $476.03 / $687.67	Professional		$286.33	$476.03	$687.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.23 / $153.08 / $223.95	Professional	26	$93.23	$153.08	$223.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $191.20 / $321.41 / $463.71	Professional	TC	$191.20	$321.41	$463.71
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $246.35 / $442.35 / $811.17	Professional		$246.35	$442.35	$811.17
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $83.32 / $148.08 / $274.45	Professional	26	$83.32	$148.08	$274.45
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $162.93 / $289.56 / $536.71	Professional	TC	$162.93	$289.56	$536.71
United Facility/Professional Professional Modifier Low / Median / High Price $316.36 / $383.27 / $1,489.31	Professional		$316.36	$383.27	$1,489.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.17 / $105.87 / $245.44	Professional	26	$74.17	$105.87	$245.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.03 / $243.02 / $1,254.01	Professional	TC	$217.03	$243.02	$1,254.01
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $244.27 / $314.27 / $482.07	Professional		$244.27	$314.27	$482.07
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $61.50 / $73.19 / $99.01	Professional	26	$61.50	$73.19	$99.01
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $170.38 / $243.55 / $340.94	Professional	TC	$170.38	$243.55	$340.94