Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.18 / $105.15 / $166.64	Facility	26	$55.18	$105.15	$166.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.67 / $425.02 / $676.41	Professional		$338.67	$425.02	$676.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $55.19 / $105.15	Professional	26	$49.69	$55.19	$105.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $286.04 / $369.97 / $565.73	Professional	TC	$286.04	$369.97	$565.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $384.51 / $526.53 / $1,069.63	Professional		$384.51	$526.53	$1,069.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.58 / $78.53 / $178.05	Professional	26	$59.58	$78.53	$178.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $437.65 / $637.40 / $1,020.10	Professional		$437.65	$637.40	$1,020.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $78.20 / $138.24	Professional	26	$53.70	$78.20	$138.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $383.95 / $559.20 / $830.55	Professional	TC	$383.95	$559.20	$830.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $307.98 / $669.39 / $1,345.73	Professional		$307.98	$669.39	$1,345.73
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 $259.58 / $585.14 / $1,182.13	Professional	TC	$259.58	$585.14	$1,182.13
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $501.02 / $825.93 / $1,546.40	Professional		$501.02	$825.93	$1,546.40
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 $439.55 / $723.06 / $1,356.67	Professional	TC	$439.55	$723.06	$1,356.67
United Facility/Professional Professional Modifier Low / Median / High Price $282.33 / $596.82 / $1,488.36	Professional		$282.33	$596.82	$1,488.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.76 / $87.45 / $195.96	Professional	26	$63.76	$87.45	$195.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.87 / $537.76 / $1,292.40	Professional	TC	$245.87	$537.76	$1,292.40
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $260.93 / $404.08 / $619.82	Professional		$260.93	$404.08	$619.82
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $44.63 / $53.10 / $69.83	Professional	26	$44.63	$53.10	$69.83
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $213.02 / $352.38 / $493.31	Professional	TC	$213.02	$352.38	$493.31