Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.87 / $71.87 / $138.40	Facility	26	$71.87	$71.87	$138.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.74 / $342.85 / $359.40	Professional		$338.74	$342.85	$359.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.36 / $68.56 / $71.88	Professional	26	$56.36	$68.56	$71.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $274.27 / $282.38 / $287.52	Professional	TC	$274.27	$282.38	$287.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $90.31 / $90.31 / $90.31	Professional	26	$90.31	$90.31	$90.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $377.48 / $806.51 / $1,169.43	Professional		$377.48	$806.51	$1,169.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.19 / $149.97 / $217.45	Professional	26	$70.19	$149.97	$217.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $307.29 / $656.55 / $951.99	Professional	TC	$307.29	$656.55	$951.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $504.50 / $910.79 / $1,219.15	Professional		$504.50	$910.79	$1,219.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.72 / $165.10 / $218.01	Professional	26	$91.72	$165.10	$218.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $412.78 / $749.53 / $1,003.29	Professional	TC	$412.78	$749.53	$1,003.29
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $439.53 / $776.27 / $1,537.51	Professional		$439.53	$776.27	$1,537.51
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $81.56 / $142.51 / $264.70	Professional	26	$81.56	$142.51	$264.70
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $357.10 / $623.86 / $1,158.83	Professional	TC	$357.10	$623.86	$1,158.83
United Facility/Professional Professional Modifier Low / Median / High Price $393.27 / $572.63 / $823.31	Professional		$393.27	$572.63	$823.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.20 / $108.95 / $221.13	Professional	26	$84.20	$108.95	$221.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $309.07 / $477.31 / $670.23	Professional	TC	$309.07	$477.31	$670.23
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $365.41 / $493.30 / $3,000.00	Professional		$365.41	$493.30	$3,000.00
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $58.57 / $68.90 / $104.06	Professional	26	$58.57	$68.90	$104.06
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $304.22 / $357.90 / $540.52	Professional	TC	$304.22	$357.90	$540.52