Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.68 / $577.79 / $1,724.81	Facility		$190.68	$577.79	$1,724.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.05 / $53.48 / $91.31	Facility	26	$29.05	$53.48	$91.31
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $161.62 / $486.48 / $1,642.39	Facility	TC	$161.62	$486.48	$1,642.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.49 / $199.83 / $532.65	Professional		$178.49	$199.83	$532.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $37.10 / $79.56	Professional	26	$26.96	$37.10	$79.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $161.62 / $198.37 / $453.10	Professional	TC	$161.62	$198.37	$453.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $174.82 / $185.13 / $252.65	Professional		$174.82	$185.13	$252.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.11 / $28.82 / $66.70	Professional	26	$27.11	$28.82	$66.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.01 / $259.83 / $458.44	Professional		$229.01	$259.83	$458.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.58 / $40.36 / $64.50	Professional	26	$35.58	$40.36	$64.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $193.43 / $219.47 / $356.96	Professional	TC	$193.43	$219.47	$356.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $952.21 / $1,430.66 / $1,786.35	Facility		$952.21	$1,430.66	$1,786.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.79 / $439.88 / $666.74	Professional		$269.79	$439.88	$666.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.56 / $56.11 / $99.93	Professional	26	$40.56	$56.11	$99.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.95 / $374.46 / $566.82	Professional	TC	$228.95	$374.46	$566.82
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $262.17 / $465.93 / $863.61	Professional		$262.17	$465.93	$863.61
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $40.72 / $70.45 / $125.71	Professional	26	$40.72	$70.45	$125.71
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $221.44 / $388.92 / $683.47	Professional	TC	$221.44	$388.92	$683.47
United Facility/Professional Professional Modifier Low / Median / High Price $258.76 / $426.49 / $871.53	Professional		$258.76	$426.49	$871.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.06 / $62.42 / $132.35	Professional	26	$40.06	$62.42	$132.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $255.17 / $364.53 / $740.26	Professional	TC	$255.17	$364.53	$740.26
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $205.44 / $254.75 / $371.04	Professional		$205.44	$254.75	$371.04
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $26.10 / $34.43 / $44.91	Professional	26	$26.10	$34.43	$44.91
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $175.50 / $210.60 / $332.40	Professional	TC	$175.50	$210.60	$332.40