Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $229.09 / $562.34	Facility	26	$131.83	$229.09	$562.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $724.44 / $1,548.82	Professional		$575.44	$724.44	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $147.91 / $436.52	Professional	26	$112.20	$147.91	$436.52
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $295.12 / $371.54 / $1,258.93	Professional	52	$295.12	$371.54	$1,258.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $549.54 / $1,202.26	Professional	TC	$457.09	$549.54	$1,202.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Professional		$588.84	$588.84	$588.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $128.82 / $389.05	Professional	26	$112.20	$128.82	$389.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,023.29 / $1,445.44	Professional		$707.95	$1,023.29	$1,445.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $190.55 / $269.15	Professional	26	$123.03	$190.55	$269.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $831.76 / $1,174.90	Professional	TC	$588.84	$831.76	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,148.15 / $2,238.72	Professional		$776.25	$1,148.15	$2,238.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $229.09 / $436.52	Professional	26	$138.04	$229.09	$436.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $912.01 / $1,862.09	Professional	TC	$630.96	$912.01	$1,862.09
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,174.90 / $1,862.09	Professional		$776.25	$1,174.90	$1,862.09
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $204.17 / $331.13	Professional	26	$134.90	$204.17	$331.13
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $977.24 / $1,548.82	Professional	TC	$645.65	$977.24	$1,548.82
United Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,148.15 / $1,995.26	Professional		$741.31	$1,148.15	$1,995.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $208.93 / $354.81	Professional	26	$134.90	$208.93	$354.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $616.60 / $891.25 / $1,548.82	Professional	TC	$616.60	$891.25	$1,548.82
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $75.86 / $89.13	Facility	26	$75.86	$75.86	$89.13