Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $524.81 / $1,174.90	Professional		$389.05	$524.81	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $275.42 / $575.44	Professional	26	$190.55	$275.42	$575.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $275.42 / $602.56	Professional	TC	$229.09	$275.42	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Professional		$1,148.15	$1,148.15	$1,148.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $295.12 / $741.31	Professional	26	$181.97	$295.12	$741.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $676.08 / $954.99	Professional		$478.63	$676.08	$954.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $316.23 / $457.09	Professional	26	$223.87	$316.23	$457.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $338.84 / $501.19	Professional	TC	$251.19	$338.84	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,047.13 / $1,412.54	Professional		$588.84	$1,047.13	$1,412.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $501.19 / $676.08	Professional	26	$269.15	$501.19	$676.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $549.54 / $831.76	Professional	TC	$316.23	$549.54	$831.76
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $933.25 / $1,479.11	Professional		$549.54	$933.25	$1,479.11
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $446.68 / $676.08	Professional	26	$263.03	$446.68	$676.08
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $501.19 / $758.58	Professional	TC	$295.12	$501.19	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $645.65 / $1,479.11	Professional		$524.81	$645.65	$1,479.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $245.47 / $295.12 / $660.69	Professional	26	$245.47	$295.12	$660.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $338.84 / $794.33	Professional	TC	$275.42	$338.84	$794.33
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	26	$169.82	$169.82	$169.82