Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $149.27 / $149.27 / $233.68	Facility	26	$149.27	$149.27	$233.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.07 / $288.47 / $288.47	Professional		$219.07	$288.47	$288.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.03 / $149.27 / $149.27	Professional	26	$110.03	$149.27	$149.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.04 / $139.19 / $139.19	Professional	TC	$109.04	$139.19	$139.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $146.33 / $146.33 / $146.33	Professional	26	$146.33	$146.33	$146.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $283.36 / $402.43 / $583.52	Professional		$283.36	$402.43	$583.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $149.44 / $212.24 / $307.74	Professional	26	$149.44	$212.24	$307.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $133.91 / $190.19 / $275.77	Professional	TC	$133.91	$190.19	$275.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $375.77 / $617.89 / $874.84	Professional		$375.77	$617.89	$874.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $195.99 / $313.63 / $454.61	Professional	26	$195.99	$313.63	$454.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.78 / $292.61 / $420.23	Professional	TC	$179.78	$292.61	$420.23
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $324.51 / $618.01 / $1,154.10	Professional		$324.51	$618.01	$1,154.10
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $171.15 / $304.04 / $563.54	Professional	26	$171.15	$304.04	$563.54
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $153.36 / $275.38 / $504.99	Professional	TC	$153.36	$275.38	$504.99
United Facility/Professional Professional Modifier Low / Median / High Price $303.63 / $377.11 / $1,381.34	Professional		$303.63	$377.11	$1,381.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $162.38 / $197.89 / $524.41	Professional	26	$162.38	$197.89	$524.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.75 / $187.59 / $593.35	Professional	TC	$159.75	$187.59	$593.35
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $229.82 / $268.43 / $405.40	Professional		$229.82	$268.43	$405.40
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $117.90 / $138.69 / $191.17	Professional	26	$117.90	$138.69	$191.17
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $110.27 / $129.72 / $190.10	Professional	TC	$110.27	$129.72	$190.10