Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.16 / $546.23 / $995.62	Facility		$179.16	$546.23	$995.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.80 / $49.86 / $70.70	Facility	26	$22.80	$49.86	$70.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.71 / $179.17 / $495.53	Professional		$143.71	$179.17	$495.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.76 / $22.81 / $58.85	Professional	26	$20.76	$22.81	$58.85
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $71.86 / $71.86 / $89.59	Professional	52	$71.86	$71.86	$89.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.95 / $156.37 / $436.71	Professional	TC	$122.95	$156.37	$436.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.02 / $16.29 / $18.32	Professional	26	$7.02	$16.29	$18.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.83 / $142.76 / $248.61	Professional		$125.83	$142.76	$248.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $23.12 / $37.29	Professional	26	$20.38	$23.12	$37.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $105.45 / $119.64 / $207.92	Professional	TC	$105.45	$119.64	$207.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $499.54 / $873.18 / $941.66	Facility		$499.54	$873.18	$941.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.09 / $247.20 / $361.16	Professional		$148.09	$247.20	$361.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.32 / $37.90 / $56.58	Professional	26	$23.32	$37.90	$56.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.77 / $207.22 / $303.75	Professional	TC	$124.77	$207.22	$303.75
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $144.05 / $256.01 / $474.52	Professional		$144.05	$256.01	$474.52
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $23.33 / $40.36 / $72.01	Professional	26	$23.33	$40.36	$72.01
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $120.72 / $212.02 / $372.60	Professional	TC	$120.72	$212.02	$372.60
United Facility/Professional Professional Modifier Low / Median / High Price $153.80 / $230.23 / $470.32	Professional		$153.80	$230.23	$470.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.33 / $35.38 / $75.01	Professional	26	$23.33	$35.38	$75.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.72 / $194.66 / $379.89	Professional	TC	$120.72	$194.66	$379.89
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $117.68 / $147.19 / $202.62	Professional		$117.68	$147.19	$202.62
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $16.93 / $20.22 / $27.26	Professional	26	$16.93	$20.22	$27.26
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $38.02 / $45.62 / $51.33	Professional	52	$38.02	$45.62	$51.33
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $90.05 / $111.66 / $170.55	Professional	TC	$90.05	$111.66	$170.55