Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.50 / $127.50 / $164.19	Facility	26	$127.50	$127.50	$164.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $454.80 / $589.03	Professional		$370.50	$454.80	$589.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $140.00 / $229.50	Professional	26	$111.15	$140.00	$229.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $312.27 / $431.70	Professional	TC	$259.35	$312.27	$431.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $273.91 / $273.91 / $275.95	Professional		$273.91	$273.91	$275.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $84.64 / $121.82 / $348.24	Professional	26	$84.64	$121.82	$348.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $336.73 / $719.44 / $1,031.59	Professional		$336.73	$719.44	$1,031.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $105.45 / $225.30 / $318.61	Professional	26	$105.45	$225.30	$318.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $231.28 / $494.14 / $708.54	Professional	TC	$231.28	$494.14	$708.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $448.43 / $756.83 / $1,077.61	Professional		$448.43	$756.83	$1,077.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.85 / $220.10 / $322.89	Professional	26	$134.85	$220.10	$322.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $310.70 / $529.50 / $754.73	Professional	TC	$310.70	$529.50	$754.73
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $385.48 / $685.08 / $1,269.81	Professional		$385.48	$685.08	$1,269.81
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $120.72 / $214.54 / $397.66	Professional	26	$120.72	$214.54	$397.66
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $264.76 / $470.53 / $872.15	Professional	TC	$264.76	$470.53	$872.15
United Facility/Professional Professional Modifier Low / Median / High Price $426.39 / $605.76 / $1,538.06	Professional		$426.39	$605.76	$1,538.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.16 / $152.94 / $229.41	Professional	26	$77.16	$152.94	$229.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $357.80 / $586.44 / $1,214.22	Professional	TC	$357.80	$586.44	$1,214.22
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $367.98 / $429.80 / $649.12	Professional		$367.98	$429.80	$649.12
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $88.00 / $105.13 / $142.22	Professional	26	$88.00	$105.13	$142.22
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $277.63 / $326.62 / $450.19	Professional	TC	$277.63	$326.62	$450.19