Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.69 / $349.14 / $349.14	Facility		$197.69	$349.14	$349.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.84 / $38.11 / $38.11	Facility	26	$32.84	$38.11	$38.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.81 / $126.72 / $250.78	Professional		$103.81	$126.72	$250.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.71 / $22.28 / $32.74	Professional	26	$12.71	$22.28	$32.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.53 / $115.57 / $209.33	Professional	TC	$81.53	$115.57	$209.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.71 / $107.71 / $113.49	Professional		$107.71	$107.71	$113.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.27 / $18.27 / $18.98	Professional	26	$18.27	$18.27	$18.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.41 / $159.28 / $223.32	Professional		$128.41	$159.28	$223.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.86 / $24.82 / $34.99	Professional	26	$21.86	$24.82	$34.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.42 / $132.66 / $188.33	Professional	TC	$106.42	$132.66	$188.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $577.65 / $641.72 / $1,067.39	Facility		$577.65	$641.72	$1,067.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.17 / $261.32 / $407.26	Professional		$165.17	$261.32	$407.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.50 / $31.95 / $61.66	Professional	26	$17.50	$31.95	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.10 / $222.15 / $345.60	Professional	TC	$140.10	$222.15	$345.60
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $160.71 / $241.06 / $496.03	Professional		$160.71	$241.06	$496.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $25.18 / $37.77 / $77.72	Professional	26	$25.18	$37.77	$77.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $135.53 / $203.30 / $418.31	Professional	TC	$135.53	$203.30	$418.31
United Facility/Professional Professional Modifier Low / Median / High Price $167.45 / $232.46 / $416.10	Professional		$167.45	$232.46	$416.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.82 / $33.47 / $64.38	Professional	26	$18.82	$33.47	$64.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.58 / $214.44 / $347.61	Professional	TC	$140.58	$214.44	$347.61
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $108.99 / $149.97 / $215.68	Professional		$108.99	$149.97	$215.68
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $11.05 / $20.83 / $28.41	Professional	26	$11.05	$20.83	$28.41
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $90.05 / $112.56 / $194.92	Professional	TC	$90.05	$112.56	$194.92