Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $642.97 / $1,440.24 / $1,440.24	Facility	26	$642.97	$1,440.24	$1,440.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,542.03 / $1,889.42 / $5,878.67	Professional		$1,542.03	$1,889.42	$5,878.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $302.10 / $347.37 / $1,025.26	Professional	26	$302.10	$347.37	$1,025.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,239.94 / $1,726.05 / $4,853.39	Professional	TC	$1,239.94	$1,726.05	$4,853.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,455.97 / $1,455.97 / $1,712.90	Professional		$1,455.97	$1,455.97	$1,712.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $402.61 / $580.75 / $1,363.72	Professional	26	$402.61	$580.75	$1,363.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,797.82 / $2,553.35 / $3,702.35	Professional		$1,797.82	$2,553.35	$3,702.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $411.12 / $583.90 / $846.65	Professional	26	$411.12	$583.90	$846.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,386.69 / $1,969.45 / $2,855.70	Professional	TC	$1,386.69	$1,969.45	$2,855.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,401.19 / $4,039.41 / $5,691.16	Professional		$2,401.19	$4,039.41	$5,691.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $507.37 / $864.61 / $1,253.33	Professional	26	$507.37	$864.61	$1,253.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,861.94 / $3,140.60 / $4,590.13	Professional	TC	$1,861.94	$3,140.60	$4,590.13
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $2,058.94 / $3,907.47 / $6,779.69	Professional		$2,058.94	$3,907.47	$6,779.69
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $470.84 / $845.45 / $1,550.37	Professional	26	$470.84	$845.45	$1,550.37
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $1,588.12 / $2,851.68 / $5,229.32	Professional	TC	$1,588.12	$2,851.68	$5,229.32
United Facility/Professional Professional Modifier Low / Median / High Price $2,039.93 / $2,506.08 / $6,308.79	Professional		$2,039.93	$2,506.08	$6,308.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $389.69 / $544.23 / $1,442.68	Professional	26	$389.69	$544.23	$1,442.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,650.24 / $2,053.46 / $6,493.87	Professional	TC	$1,650.24	$2,053.46	$6,493.87
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $1,543.26 / $1,851.91 / $2,722.31	Professional		$1,543.26	$1,851.91	$2,722.31
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $324.27 / $381.50 / $525.84	Professional	26	$324.27	$381.50	$525.84
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $1,216.63 / $1,459.96 / $2,236.19	Professional	TC	$1,216.63	$1,459.96	$2,236.19