Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.48 / $118.20 / $309.57	Facility	26	$93.48	$118.20	$309.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.65 / $269.73 / $567.85	Professional		$255.65	$269.73	$567.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.29 / $93.49 / $242.61	Professional	26	$81.29	$93.49	$242.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $164.36 / $172.59 / $458.95	Professional	TC	$164.36	$172.59	$458.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $540.32 / $540.32 / $540.32	Professional		$540.32	$540.32	$540.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $90.62 / $95.26 / $108.75	Professional	26	$90.62	$95.26	$108.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.54 / $479.47 / $829.10	Professional		$222.54	$479.47	$829.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.28 / $164.65 / $283.97	Professional	26	$78.28	$164.65	$283.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.27 / $303.45 / $523.35	Professional	TC	$144.27	$303.45	$523.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.76 / $451.61 / $682.44	Professional		$291.76	$451.61	$682.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.08 / $156.00 / $234.06	Professional	26	$102.08	$156.00	$234.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.86 / $291.95 / $448.38	Professional	TC	$188.86	$291.95	$448.38
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $254.77 / $440.70 / $839.24	Professional		$254.77	$440.70	$839.24
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $89.61 / $150.16 / $295.18	Professional	26	$89.61	$150.16	$295.18
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $165.15 / $285.68 / $509.74	Professional	TC	$165.15	$285.68	$509.74
United Facility/Professional Professional Modifier Low / Median / High Price $300.87 / $401.91 / $737.41	Professional		$300.87	$401.91	$737.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.61 / $141.16 / $263.95	Professional	26	$89.61	$141.16	$263.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.15 / $248.32 / $474.99	Professional	TC	$165.15	$248.32	$474.99
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $196.64 / $235.97 / $355.05	Professional		$196.64	$235.97	$355.05
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $65.56 / $78.68 / $115.67	Professional	26	$65.56	$78.68	$115.67
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $121.89 / $146.27 / $215.01	Professional	TC	$121.89	$146.27	$215.01