Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.17 / $169.44 / $525.20	Facility	26	$127.17	$169.44	$525.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $555.67 / $699.70 / $1,108.39	Professional		$555.67	$699.70	$1,108.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.86 / $127.17 / $216.20	Professional	26	$103.86	$127.17	$216.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $247.60 / $320.01 / $442.29	Professional	52	$247.60	$320.01	$442.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $451.82 / $562.25 / $892.19	Professional	TC	$451.82	$562.25	$892.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $116.35 / $129.90 / $371.36	Professional	26	$116.35	$129.90	$371.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $595.91 / $746.24 / $1,225.07	Professional		$595.91	$746.24	$1,225.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.24 / $144.52 / $225.99	Professional	26	$112.24	$144.52	$225.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $485.45 / $601.73 / $999.06	Professional	TC	$485.45	$601.73	$999.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $739.57 / $1,075.22 / $1,858.05	Professional		$739.57	$1,075.22	$1,858.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $133.59 / $218.45 / $396.48	Professional	26	$133.59	$218.45	$396.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $605.97 / $871.29 / $1,492.29	Professional	TC	$605.97	$871.29	$1,492.29
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $696.53 / $1,148.23 / $2,149.84	Professional		$696.53	$1,148.23	$2,149.84
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $128.49 / $211.37 / $396.58	Professional	26	$128.49	$211.37	$396.58
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $568.04 / $934.43 / $1,753.26	Professional	TC	$568.04	$934.43	$1,753.26
United Facility/Professional Professional Modifier Low / Median / High Price $728.79 / $1,028.77 / $2,089.16	Professional		$728.79	$1,028.77	$2,089.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $136.96 / $207.26 / $408.62	Professional	26	$136.96	$207.26	$408.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $596.54 / $827.55 / $1,680.54	Professional	TC	$596.54	$827.55	$1,680.54
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $540.95 / $618.85 / $928.28	Professional		$540.95	$618.85	$928.28
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $93.45 / $130.83 / $183.05	Professional	26	$93.45	$130.83	$183.05
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $172.89 / $207.47 / $233.40	Professional	52	$172.89	$207.47	$233.40
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $398.32 / $493.64 / $740.46	Professional	TC	$398.32	$493.64	$740.46