Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.70 / $371.93 / $796.15	Facility		$121.70	$371.93	$796.15
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.89 / $32.52 / $61.54	Facility	26	$19.89	$32.52	$61.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.70 / $146.54 / $335.60	Professional		$121.70	$146.54	$335.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $22.99 / $53.95	Professional	26	$19.89	$22.99	$53.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.81 / $122.99 / $284.31	Professional	TC	$101.81	$122.99	$284.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.11 / $105.11 / $105.11	Professional		$105.11	$105.11	$105.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.37 / $17.62 / $71.27	Professional	26	$16.37	$17.62	$71.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.09 / $155.97 / $246.72	Professional		$128.09	$155.97	$246.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.67 / $24.59 / $39.44	Professional	26	$21.67	$24.59	$39.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.42 / $131.38 / $203.47	Professional	TC	$106.42	$131.38	$203.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $498.23 / $675.96 / $1,037.33	Facility		$498.23	$675.96	$1,037.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.87 / $261.43 / $399.26	Professional		$161.87	$261.43	$399.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.70 / $35.29 / $61.10	Professional	26	$24.70	$35.29	$61.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.03 / $222.34 / $338.16	Professional	TC	$137.03	$222.34	$338.16
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $157.38 / $279.70 / $518.42	Professional		$157.38	$279.70	$518.42
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $24.81 / $42.92 / $76.58	Professional	26	$24.81	$42.92	$76.58
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $132.57 / $229.32 / $409.18	Professional	TC	$132.57	$229.32	$409.18
United Facility/Professional Professional Modifier Low / Median / High Price $169.33 / $253.66 / $515.13	Professional		$169.33	$253.66	$515.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.90 / $38.76 / $81.53	Professional	26	$24.90	$38.76	$81.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $149.46 / $213.52 / $433.60	Professional	TC	$149.46	$213.52	$433.60
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $119.45 / $149.41 / $208.51	Professional		$119.45	$149.41	$208.51
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $17.84 / $21.33 / $27.83	Professional	26	$17.84	$21.33	$27.83
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $90.05 / $111.66 / $172.96	Professional	TC	$90.05	$111.66	$172.96