Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.60 / $678.15 / $1,181.93	Facility		$124.60	$678.15	$1,181.93
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.80 / $30.17 / $71.37	Facility	26	$22.80	$30.17	$71.37
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $101.81 / $146.37 / $832.02	Facility	TC	$101.81	$146.37	$832.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.57 / $125.37 / $293.37	Professional		$116.57	$125.37	$293.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.13 / $22.81 / $58.85	Professional	26	$21.13	$22.81	$58.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.81 / $104.24 / $284.31	Professional	TC	$101.81	$104.24	$284.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.49 / $94.15 / $279.14	Professional		$87.49	$94.15	$279.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.31 / $16.78 / $47.70	Professional	26	$15.31	$16.78	$47.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.51 / $129.91 / $222.67	Professional		$114.51	$129.91	$222.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $22.75 / $37.29	Professional	26	$20.05	$22.75	$37.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.45 / $107.16 / $177.92	Professional	TC	$94.45	$107.16	$177.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $460.48 / $641.72 / $817.14	Facility		$460.48	$641.72	$817.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.83 / $230.38 / $330.03	Professional		$134.83	$230.38	$330.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.04 / $37.44 / $55.92	Professional	26	$23.04	$37.44	$55.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.79 / $190.81 / $274.11	Professional	TC	$111.79	$190.81	$274.11
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $131.09 / $235.48 / $431.82	Professional		$131.09	$235.48	$431.82
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $22.96 / $39.72 / $70.87	Professional	26	$22.96	$39.72	$70.87
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $108.13 / $191.76 / $333.74	Professional	TC	$108.13	$191.76	$333.74
United Facility/Professional Professional Modifier Low / Median / High Price $141.46 / $205.76 / $417.85	Professional		$141.46	$205.76	$417.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.96 / $35.99 / $74.56	Professional	26	$22.96	$35.99	$74.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.03 / $176.14 / $346.10	Professional	TC	$118.03	$176.14	$346.10
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $108.26 / $131.83 / $186.41	Professional		$108.26	$131.83	$186.41
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $17.02 / $20.82 / $27.40	Professional	26	$17.02	$20.82	$27.40
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $81.40 / $100.94 / $154.16	Professional	TC	$81.40	$100.94	$154.16