Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.96 / $270.50 / $1,422.90	Facility		$194.96	$270.50	$1,422.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.21 / $55.08 / $102.65	Facility	26	$33.21	$55.08	$102.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.97 / $196.75 / $537.45	Professional		$194.97	$196.75	$537.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $36.54 / $85.70	Professional	26	$33.22	$36.54	$85.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $160.19 / $161.75 / $451.72	Professional	TC	$160.19	$161.75	$451.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.15 / $134.15 / $134.15	Professional		$134.15	$134.15	$134.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.38 / $30.61 / $50.68	Professional	26	$29.38	$30.61	$50.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.02 / $197.45 / $344.00	Professional		$174.02	$197.45	$344.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.88 / $41.84 / $64.59	Professional	26	$36.88	$41.84	$64.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.15 / $155.61 / $258.81	Professional	TC	$137.15	$155.61	$258.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $669.43 / $1,168.06 / $1,395.81	Facility		$669.43	$1,168.06	$1,395.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.39 / $337.58 / $499.10	Professional		$204.39	$337.58	$499.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.23 / $57.56 / $100.49	Professional	26	$41.23	$57.56	$100.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.32 / $277.04 / $398.61	Professional	TC	$162.32	$277.04	$398.61
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $199.22 / $353.30 / $656.25	Professional		$199.22	$353.30	$656.25
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $42.21 / $73.01 / $130.28	Professional	26	$42.21	$73.01	$130.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $157.01 / $271.60 / $484.61	Professional	TC	$157.01	$271.60	$484.61
United Facility/Professional Professional Modifier Low / Median / High Price $199.22 / $306.87 / $645.35	Professional		$199.22	$306.87	$645.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.42 / $63.12 / $133.38	Professional	26	$40.42	$63.12	$133.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.88 / $252.64 / $513.04	Professional	TC	$177.88	$252.64	$513.04
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $166.90 / $188.15 / $282.20	Professional		$166.90	$188.15	$282.20
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $29.48 / $35.15 / $45.14	Professional	26	$29.48	$35.15	$45.14
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $121.64 / $150.83 / $230.39	Professional	TC	$121.64	$150.83	$230.39