Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.50 / $281.18 / $281.18	Facility	26	$125.50	$281.18	$281.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $409.29 / $539.90 / $1,497.00	Professional		$409.29	$539.90	$1,497.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.97 / $76.81 / $205.10	Professional	26	$58.97	$76.81	$205.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $350.32 / $463.09 / $1,281.38	Professional	TC	$350.32	$463.09	$1,281.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,043.80 / $1,043.80 / $1,043.80	Professional		$1,043.80	$1,043.80	$1,043.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $78.56 / $113.36 / $266.19	Professional	26	$78.56	$113.36	$266.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $427.62 / $607.33 / $880.62	Professional		$427.62	$607.33	$880.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.22 / $113.93 / $165.19	Professional	26	$80.22	$113.93	$165.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $347.40 / $493.40 / $715.43	Professional	TC	$347.40	$493.40	$715.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $572.05 / $1,012.95 / $1,523.48	Professional		$572.05	$1,012.95	$1,523.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.52 / $169.60 / $245.83	Professional	26	$99.52	$169.60	$245.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $466.81 / $841.72 / $1,309.58	Professional	TC	$466.81	$841.72	$1,309.58
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $489.74 / $932.67 / $1,612.59	Professional		$489.74	$932.67	$1,612.59
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $91.87 / $164.97 / $302.50	Professional	26	$91.87	$164.97	$302.50
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $397.86 / $714.41 / $1,310.06	Professional	TC	$397.86	$714.41	$1,310.06
United Facility/Professional Professional Modifier Low / Median / High Price $428.73 / $654.47 / $1,500.59	Professional		$428.73	$654.47	$1,500.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.20 / $107.13 / $392.44	Professional	26	$76.20	$107.13	$392.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $386.70 / $547.34 / $1,116.49	Professional	TC	$386.70	$547.34	$1,116.49
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $403.90 / $484.68 / $712.48	Professional		$403.90	$484.68	$712.48
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $63.84 / $75.09 / $103.28	Professional	26	$63.84	$75.09	$103.28
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $339.60 / $404.12 / $595.89	Professional	TC	$339.60	$404.12	$595.89