Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $344.57 / $821.76 / $821.76	Facility	26	$344.57	$821.76	$821.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $378.97 / $568.25 / $1,550.46	Professional		$378.97	$568.25	$1,550.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $162.51 / $225.01 / $585.29	Professional	26	$162.51	$225.01	$585.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $216.46 / $343.24 / $965.16	Professional	TC	$216.46	$343.24	$965.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,143.80 / $1,143.80 / $1,143.80	Professional		$1,143.80	$1,143.80	$1,143.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $311.22 / $527.29 / $527.29	Professional	26	$311.22	$527.29	$527.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $471.94 / $670.26 / $971.87	Professional		$471.94	$670.26	$971.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $220.28 / $312.85 / $453.63	Professional	26	$220.28	$312.85	$453.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.66 / $357.41 / $518.24	Professional	TC	$251.66	$357.41	$518.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $626.87 / $1,039.81 / $1,465.62	Professional		$626.87	$1,039.81	$1,465.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $280.52 / $463.81 / $672.34	Professional	26	$280.52	$463.81	$672.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $337.88 / $576.00 / $911.50	Professional	TC	$337.88	$576.00	$911.50
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $540.49 / $1,029.32 / $1,922.23	Professional		$540.49	$1,029.32	$1,922.23
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $252.27 / $453.00 / $830.67	Professional	26	$252.27	$453.00	$830.67
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $288.20 / $517.52 / $949.00	Professional	TC	$288.20	$517.52	$949.00
United Facility/Professional Professional Modifier Low / Median / High Price $614.41 / $791.06 / $1,553.36	Professional		$614.41	$791.06	$1,553.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $222.42 / $292.32 / $1,070.75	Professional	26	$222.42	$292.32	$1,070.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $331.98 / $458.98 / $1,258.59	Professional	TC	$331.98	$458.98	$1,258.59
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $388.49 / $479.60 / $719.40	Professional		$388.49	$479.60	$719.40
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $174.19 / $208.79 / $282.45	Professional	26	$174.19	$208.79	$282.45
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $213.05 / $255.66 / $403.52	Professional	TC	$213.05	$255.66	$403.52