Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.97 / $228.68 / $564.54	Facility	26	$132.97	$228.68	$564.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $584.29 / $730.48 / $1,158.85	Professional		$584.29	$730.48	$1,158.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.16 / $132.01 / $224.47	Professional	26	$108.16	$132.01	$224.47
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $258.47 / $336.16 / $480.85	Professional	52	$258.47	$336.16	$480.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $476.14 / $588.83 / $934.39	Professional	TC	$476.14	$588.83	$934.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.86 / $153.06 / $387.20	Professional	26	$33.86	$153.06	$387.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $622.97 / $779.05 / $1,283.03	Professional		$622.97	$779.05	$1,283.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.09 / $149.91 / $235.77	Professional	26	$117.09	$149.91	$235.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $508.05 / $629.14 / $1,047.27	Professional	TC	$508.05	$629.14	$1,047.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $774.54 / $1,160.46 / $2,049.50	Professional		$774.54	$1,160.46	$2,049.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $139.29 / $226.65 / $411.38	Professional	26	$139.29	$226.65	$411.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $635.24 / $917.71 / $1,615.41	Professional	TC	$635.24	$917.71	$1,615.41
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $729.49 / $1,202.56 / $2,251.57	Professional		$729.49	$1,202.56	$2,251.57
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $134.05 / $220.51 / $413.75	Professional	26	$134.05	$220.51	$413.75
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $595.44 / $979.50 / $1,837.83	Professional	TC	$595.44	$979.50	$1,837.83
United Facility/Professional Professional Modifier Low / Median / High Price $761.86 / $1,108.46 / $2,182.73	Professional		$761.86	$1,108.46	$2,182.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $146.33 / $208.80 / $369.86	Professional	26	$146.33	$208.80	$369.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $881.74 / $1,773.01	Professional	TC	$588.84	$881.74	$1,773.01
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $565.22 / $683.08 / $973.21	Professional		$565.22	$683.08	$973.21
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $96.97 / $135.76 / $196.75	Professional	26	$96.97	$135.76	$196.75
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $188.94 / $226.73 / $255.07	Professional	52	$188.94	$226.73	$255.07
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $521.09 / $789.55	Professional	TC	$416.87	$521.09	$789.55