Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.14 / $315.89 / $646.23	Facility		$50.14	$315.89	$646.23
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.47 / $16.01 / $40.29	Facility	26	$11.47	$16.01	$40.29
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.82 / $98.99 / $459.98	Facility	TC	$29.82	$98.99	$459.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.31 / $41.29 / $103.17	Professional		$27.31	$41.29	$103.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $11.47 / $29.88	Professional	26	$8.52	$11.47	$29.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.78 / $29.82 / $83.20	Professional	TC	$18.78	$29.82	$83.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.56 / $41.05 / $93.62	Professional		$29.56	$41.05	$93.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $13.33 / $34.26	Professional	26	$7.92	$13.33	$34.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $163.89 / $205.96 / $228.80	Facility		$163.89	$205.96	$228.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.49 / $56.51 / $79.91	Professional		$38.49	$56.51	$79.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $15.20 / $21.49	Professional	26	$10.35	$15.20	$21.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.14 / $41.32 / $58.43	Professional	TC	$28.14	$41.32	$58.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.29 / $195.54 / $640.01	Facility		$137.29	$195.54	$640.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $196.26 / $196.26 / $196.26	Facility	TC	$196.26	$196.26	$196.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.57 / $77.15 / $122.44	Professional		$49.57	$77.15	$122.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.23 / $21.70 / $32.04	Professional	26	$13.23	$21.70	$32.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.59 / $54.06 / $90.40	Professional	TC	$36.59	$54.06	$90.40
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $44.07 / $72.65 / $145.16	Professional		$44.07	$72.65	$145.16
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $11.85 / $19.48 / $39.04	Professional	26	$11.85	$19.48	$39.04
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $32.22 / $55.73 / $106.14	Professional	TC	$32.22	$55.73	$106.14
United Facility/Professional Professional Modifier Low / Median / High Price $39.14 / $49.51 / $96.40	Professional		$39.14	$49.51	$96.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.71 / $14.51 / $28.60	Professional	26	$10.71	$14.51	$28.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.82 / $36.63 / $62.05	Professional	TC	$27.82	$36.63	$62.05
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $30.38 / $36.46 / $53.59	Professional		$30.38	$36.46	$53.59
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $10.25 / $13.99	Professional	26	$8.63	$10.25	$13.99
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $21.53 / $26.03 / $34.92	Professional	TC	$21.53	$26.03	$34.92