Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.42 / $81.23 / $166.64	Facility	26	$55.42	$81.23	$166.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $296.76 / $368.26 / $580.66	Professional		$296.76	$368.26	$580.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $55.42 / $132.81	Professional	26	$49.69	$55.42	$132.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $250.15 / $310.72 / $514.42	Professional	TC	$250.15	$310.72	$514.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $330.33 / $453.01 / $918.22	Professional		$330.33	$453.01	$918.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.59 / $62.28 / $78.53	Professional	26	$51.59	$62.28	$78.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $375.87 / $547.41 / $885.58	Professional		$375.87	$547.41	$885.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $78.20 / $116.14	Professional	26	$53.70	$78.20	$116.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $322.17 / $469.22 / $696.91	Professional	TC	$322.17	$469.22	$696.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $304.12 / $584.91 / $1,159.48	Professional		$304.12	$584.91	$1,159.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.05 / $96.91 / $163.60	Professional	26	$64.05	$96.91	$163.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $230.30 / $497.23 / $995.88	Professional	TC	$230.30	$497.23	$995.88
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $430.29 / $709.33 / $1,328.09	Professional		$430.29	$709.33	$1,328.09
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $61.47 / $101.12 / $189.73	Professional	26	$61.47	$101.12	$189.73
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $368.82 / $606.71 / $1,138.35	Professional	TC	$368.82	$606.71	$1,138.35
United Facility/Professional Professional Modifier Low / Median / High Price $249.25 / $539.74 / $1,252.66	Professional		$249.25	$539.74	$1,252.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.51 / $83.90 / $194.72	Professional	26	$64.51	$83.90	$194.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.56 / $520.96 / $1,066.61	Professional	TC	$257.56	$520.96	$1,066.61
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $237.47 / $339.85 / $521.29	Professional		$237.47	$339.85	$521.29
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $44.34 / $53.10 / $70.14	Professional	26	$44.34	$53.10	$70.14
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $189.32 / $288.49 / $403.86	Professional	TC	$189.32	$288.49	$403.86