Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.49 / $347.33 / $589.50	Facility		$41.49	$347.33	$589.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $12.03 / $31.04	Facility	26	$8.32	$12.03	$31.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.33 / $41.56 / $382.50	Facility	TC	$26.33	$41.56	$382.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.58 / $34.65 / $79.09	Professional		$24.58	$34.65	$79.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.67 / $8.25 / $21.62	Professional	26	$6.67	$8.25	$21.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.91 / $26.33 / $74.03	Professional	TC	$17.91	$26.33	$74.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.37 / $33.79 / $77.09	Professional		$24.37	$33.79	$77.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $7.94 / $26.73	Professional	26	$6.19	$7.94	$26.73
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.56 / $36.56 / $36.56	Professional	50	$36.56	$36.56	$36.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.93 / $169.57 / $188.37	Facility		$134.93	$169.57	$188.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.70 / $46.54 / $65.81	Professional		$31.70	$46.54	$65.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $11.87 / $16.78	Professional	26	$8.09	$11.87	$16.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $47.55 / $69.81 / $98.72	Professional	50	$47.55	$69.81	$98.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.61 / $34.67 / $49.03	Professional	TC	$23.61	$34.67	$49.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $113.85 / $186.79 / $521.64	Facility		$113.85	$186.79	$521.64
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $168.49 / $168.49 / $168.49	Facility	TC	$168.49	$168.49	$168.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.25 / $66.95 / $101.00	Professional		$42.25	$66.95	$101.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.37 / $16.94 / $25.01	Professional	26	$10.37	$16.94	$25.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.64 / $49.30 / $75.83	Professional	TC	$31.64	$49.30	$75.83
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $30.50 / $59.70 / $119.54	Professional		$30.50	$59.70	$119.54
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.26 / $14.04 / $25.99	Professional	26	$9.26	$14.04	$25.99
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $27.03 / $48.04 / $89.04	Professional	TC	$27.03	$48.04	$89.04
United Facility/Professional Professional Modifier Low / Median / High Price $34.54 / $40.82 / $80.67	Professional		$34.54	$40.82	$80.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $14.64 / $25.74	Professional	26	$8.85	$14.64	$25.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.30 / $29.09 / $58.34	Professional	TC	$23.30	$29.09	$58.34
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $24.71 / $29.65 / $43.59	Professional		$24.71	$29.65	$43.59
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $6.73 / $8.07 / $10.91	Professional	26	$6.73	$8.07	$10.91
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $17.92 / $21.33 / $31.01	Professional	TC	$17.92	$21.33	$31.01