Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.76 / $102.76 / $160.46	Facility	26	$102.76	$102.76	$160.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $369.16 / $441.05 / $622.15	Professional		$369.16	$441.05	$622.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.73 / $102.76 / $160.46	Professional	26	$75.73	$102.76	$160.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $293.43 / $338.27 / $461.70	Professional	TC	$293.43	$338.27	$461.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $372.78 / $372.78 / $372.78	Professional		$372.78	$372.78	$372.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $390.75 / $554.96 / $804.69	Professional		$390.75	$554.96	$804.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.54 / $145.63 / $211.16	Professional	26	$102.54	$145.63	$211.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $288.20 / $409.33 / $593.52	Professional	TC	$288.20	$409.33	$593.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $521.80 / $918.21 / $1,252.02	Professional		$521.80	$918.21	$1,252.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.57 / $216.04 / $314.16	Professional	26	$134.57	$216.04	$314.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $387.24 / $700.64 / $937.85	Professional	TC	$387.24	$700.64	$937.85
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $447.50 / $794.98 / $1,473.52	Professional		$447.50	$794.98	$1,473.52
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $117.44 / $210.86 / $386.69	Professional	26	$117.44	$210.86	$386.69
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $330.07 / $592.67 / $1,086.85	Professional	TC	$330.07	$592.67	$1,086.85
United Facility/Professional Professional Modifier Low / Median / High Price $476.94 / $572.33 / $1,371.17	Professional		$476.94	$572.33	$1,371.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $111.77 / $132.87 / $239.24	Professional	26	$111.77	$132.87	$239.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $350.28 / $439.46 / $864.81	Professional	TC	$350.28	$439.46	$864.81
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $364.67 / $425.93 / $690.68	Professional		$364.67	$425.93	$690.68
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $81.91 / $96.36 / $132.82	Professional	26	$81.91	$96.36	$132.82
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $280.13 / $329.56 / $497.38	Professional	TC	$280.13	$329.56	$497.38