Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.57 / $121.61 / $530.01	Facility		$34.57	$121.61	$530.01
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.02 / $14.63 / $40.29	Facility	26	$11.02	$14.63	$40.29
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.55 / $81.31 / $447.42	Facility	TC	$23.55	$81.31	$447.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.40 / $34.57 / $94.93	Professional		$24.40	$34.57	$94.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $11.02 / $28.71	Professional	26	$8.52	$11.02	$28.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.87 / $23.55 / $66.19	Professional	TC	$15.87	$23.55	$66.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.66 / $34.11 / $45.92	Professional		$24.66	$34.11	$45.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $12.08 / $31.03	Professional	26	$7.21	$12.08	$31.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.12 / $171.06 / $190.03	Facility		$136.12	$171.06	$190.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.02 / $47.02 / $67.42	Professional		$32.02	$47.02	$67.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.38 / $13.77 / $19.47	Professional	26	$9.38	$13.77	$19.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.64 / $33.24 / $47.00	Professional	TC	$22.64	$33.24	$47.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.16 / $186.79 / $640.01	Facility		$109.16	$186.79	$640.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $190.73 / $190.73 / $190.73	Facility	TC	$190.73	$190.73	$190.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.65 / $67.58 / $100.90	Professional		$42.65	$67.58	$100.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.27 / $19.66 / $29.32	Professional	26	$12.27	$19.66	$29.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.32 / $48.14 / $71.88	Professional	TC	$30.32	$48.14	$71.88
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $64.39 / $120.76	Professional		$36.65	$64.39	$120.76
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $10.74 / $16.96 / $35.38	Professional	26	$10.74	$16.96	$35.38
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $25.92 / $46.06 / $85.38	Professional	TC	$25.92	$46.06	$85.38
United Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $43.06 / $85.28	Professional		$34.17	$43.06	$85.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $13.56 / $28.59	Professional	26	$10.72	$13.56	$28.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $29.90 / $79.45	Professional	TC	$22.85	$29.90	$79.45
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $25.21 / $30.25 / $44.47	Professional		$25.21	$30.25	$44.47
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $7.87 / $9.76 / $12.69	Professional	26	$7.87	$9.76	$12.69
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $17.35 / $20.65 / $30.43	Professional	TC	$17.35	$20.65	$30.43