Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $375.93 / $843.15 / $3,118.50	Facility		$375.93	$843.15	$3,118.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.84 / $100.67 / $225.80	Facility	26	$68.84	$100.67	$225.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.93 / $243.16 / $665.36	Professional		$191.93	$243.16	$665.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.18 / $70.19 / $178.53	Professional	26	$60.18	$70.19	$178.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.18 / $174.32 / $486.83	Professional	TC	$172.18	$174.32	$486.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.55 / $153.13 / $456.40	Professional		$144.55	$153.13	$456.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.62 / $75.65 / $216.25	Professional	26	$52.62	$75.65	$216.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $86.48 / $86.48 / $86.48	Professional	TC	$86.48	$86.48	$86.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $187.93 / $405.75 / $681.78	Professional		$187.93	$405.75	$681.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.34 / $137.44 / $237.04	Professional	26	$65.34	$137.44	$237.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.59 / $257.86 / $444.74	Professional	TC	$122.59	$257.86	$444.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.13 / $386.60 / $608.88	Professional		$250.13	$386.60	$608.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.77 / $126.65 / $194.89	Professional	26	$83.77	$126.65	$194.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.62 / $266.20 / $423.17	Professional	TC	$164.62	$266.20	$423.17
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $215.14 / $377.85 / $708.69	Professional		$215.14	$377.85	$708.69
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $74.80 / $125.34 / $230.87	Professional	26	$74.80	$125.34	$230.87
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $140.34 / $246.48 / $433.16	Professional	TC	$140.34	$246.48	$433.16
United Facility/Professional Professional Modifier Low / Median / High Price $239.75 / $363.22 / $654.17	Professional		$239.75	$363.22	$654.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.84 / $117.55 / $227.64	Professional	26	$80.84	$117.55	$227.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $142.11 / $264.49 / $426.54	Professional	TC	$142.11	$264.49	$426.54
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $182.44 / $205.65 / $305.83	Professional		$182.44	$205.65	$305.83
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $56.38 / $67.09 / $87.27	Professional	26	$56.38	$67.09	$87.27
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $109.47 / $142.60 / $207.34	Professional	TC	$109.47	$142.60	$207.34