Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $177.83 / $467.74	Facility		$38.90	$177.83	$467.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.12 / $12.02 / $30.90	Facility	26	$9.12	$12.02	$30.90
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.20 / $42.66 / $436.52	Facility	TC	$18.20	$42.66	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $34.67 / $95.50	Professional		$22.91	$34.67	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.33 / $25.12	Professional	26	$7.08	$9.33	$25.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $19.95 / $60.26	Professional	TC	$15.14	$19.95	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $22.91 / $69.18	Professional		$17.78	$22.91	$69.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.51 / $26.92	Professional	26	$6.46	$8.51	$26.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $13.80 / $13.80	Professional	TC	$13.80	$13.80	$13.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $158.49 / $177.83	Facility		$125.89	$158.49	$177.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $43.65 / $58.88	Professional		$28.18	$43.65	$58.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.88 / $18.62	Professional	26	$8.32	$12.88	$18.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $30.90 / $40.74	Professional	TC	$19.50	$30.90	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $181.97 / $645.65	Facility		$120.23	$181.97	$645.65
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	TC	$147.91	$147.91	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $85.11	Professional		$36.31	$51.29	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.98 / $25.12	Professional	26	$10.00	$16.98	$25.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $39.81 / $60.26	Professional	TC	$25.70	$39.81	$60.26
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $50.12 / $74.13	Professional		$30.90	$50.12	$74.13
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $14.13 / $21.38	Professional	26	$9.55	$14.13	$21.38
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $37.15 / $54.95	Professional	TC	$22.91	$37.15	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.90 / $83.18	Professional		$28.84	$38.90	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.75 / $22.39	Professional	26	$8.51	$11.75	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.92 / $60.26	Professional	TC	$20.42	$26.92	$60.26
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Facility		$21.88	$21.88	$21.88
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $5.25 / $6.31 / $6.31	Facility	26	$5.25	$6.31	$6.31
Well Sense Facility/Professional Facility Modifier TC Low / Median / High Price $13.49 / $15.85 / $15.85	Facility	TC	$13.49	$15.85	$15.85