Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.55 / $204.00 / $464.72	Facility		$55.55	$204.00	$464.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.10 / $42.91 / $42.91	Facility	26	$13.10	$42.91	$42.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.04 / $86.76 / $479.53	Facility	TC	$32.04	$86.76	$479.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.96 / $34.78 / $103.44	Professional		$27.96	$34.78	$103.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.47 / $10.61 / $31.38	Professional	26	$9.47	$10.61	$31.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $25.64 / $72.08	Professional	TC	$18.48	$25.64	$72.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $19.82 / $27.78	Professional	26	$6.74	$19.82	$27.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $148.79 / $186.99 / $207.73	Facility		$148.79	$186.99	$207.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.93 / $51.29 / $73.54	Professional		$34.93	$51.29	$73.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $12.35 / $17.89	Professional	26	$8.41	$12.35	$17.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.52 / $38.94 / $55.06	Professional	TC	$26.52	$38.94	$55.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.91 / $195.54 / $640.01	Facility		$127.91	$195.54	$640.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $182.32 / $182.32 / $182.32	Facility	TC	$182.32	$182.32	$182.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.59 / $73.81 / $110.23	Professional		$46.59	$73.81	$110.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.99 / $17.80 / $28.43	Professional	26	$10.99	$17.80	$28.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.10 / $51.69 / $84.23	Professional	TC	$34.10	$51.69	$84.23
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $31.72 / $62.84 / $131.72	Professional		$31.72	$62.84	$131.72
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $15.13 / $27.03	Professional	26	$9.63	$15.13	$27.03
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $30.36 / $53.96 / $100.01	Professional	TC	$30.36	$53.96	$100.01
United Facility/Professional Professional Modifier Low / Median / High Price $39.99 / $54.07 / $93.90	Professional		$39.99	$54.07	$93.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $13.61 / $32.21	Professional	26	$10.83	$13.61	$32.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.65 / $33.31 / $62.37	Professional	TC	$25.65	$33.31	$62.37
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $33.61 / $50.19	Professional		$28.45	$33.61	$50.19
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $9.90 / $14.00	Professional	26	$7.92	$9.90	$14.00
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $20.38 / $23.98 / $33.04	Professional	TC	$20.38	$23.98	$33.04