Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.84 / $158.84 / $288.66	Facility	26	$158.84	$158.84	$288.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.73 / $258.33 / $399.70	Professional		$226.73	$258.33	$399.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $136.62 / $154.79 / $220.18	Professional	26	$136.62	$154.79	$220.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.20 / $106.11 / $147.36	Professional	TC	$88.20	$106.11	$147.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.93 / $274.69 / $566.58	Professional		$218.93	$274.69	$566.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $218.44 / $218.44 / $218.44	Professional	26	$218.44	$218.44	$218.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.84 / $261.73 / $396.68	Professional		$234.84	$261.73	$396.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $148.11 / $159.19 / $251.42	Professional	26	$148.11	$159.19	$251.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.39 / $98.63 / $143.66	Professional	TC	$85.39	$98.63	$143.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $282.50 / $442.27 / $737.70	Professional		$282.50	$442.27	$737.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $178.17 / $268.07 / $455.02	Professional	26	$178.17	$268.07	$455.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.33 / $169.47 / $282.68	Professional	TC	$104.33	$169.47	$282.68
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $268.83 / $442.24 / $829.77	Professional		$268.83	$442.24	$829.77
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $171.08 / $281.43 / $528.04	Professional	26	$171.08	$281.43	$528.04
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $97.76 / $161.16 / $301.74	Professional	TC	$97.76	$161.16	$301.74
United Facility/Professional Professional Modifier Low / Median / High Price $324.70 / $486.47 / $892.20	Professional		$324.70	$486.47	$892.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $186.68 / $257.22 / $539.21	Professional	26	$186.68	$257.22	$539.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.30 / $173.82 / $352.99	Professional	TC	$104.30	$173.82	$352.99
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $207.71 / $249.25 / $365.85	Professional		$207.71	$249.25	$365.85
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $123.72 / $147.22 / $218.24	Professional	26	$123.72	$147.22	$218.24
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $83.67 / $99.57 / $150.27	Professional	TC	$83.67	$99.57	$150.27