Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $338.84 / $588.84	Facility		$44.67	$338.84	$588.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $12.02 / $549.54	Facility	26	$8.32	$12.02	$549.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.30 / $41.69 / $309.03	Facility	TC	$26.30	$41.69	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $28.84 / $93.33	Professional		$8.91	$28.84	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.13 / $37.15	Professional	26	$7.08	$14.13	$37.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.90 / $131.83 / $295.12	Professional	50	$30.90	$131.83	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $26.30 / $87.10	Professional	TC	$19.05	$26.30	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $25.70 / $107.15	Professional		$21.88	$25.70	$107.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $10.47 / $26.92	Professional	26	$6.31	$10.47	$26.92
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $114.82 / $114.82 / $114.82	Professional	50	$114.82	$114.82	$114.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $28.18 / $30.90	Professional	TC	$16.22	$28.18	$30.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $186.21 / $208.93	Facility		$147.91	$186.21	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $51.29 / $74.13	Professional		$33.11	$51.29	$74.13
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 50 Low / Median / High Price $50.12 / $77.62 / $112.20	Professional	50	$50.12	$77.62	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $38.02 / $54.95	Professional	TC	$24.55	$38.02	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $208.93 / $524.81	Facility		$117.49	$208.93	$524.81
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	TC	$169.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $97.72	Professional		$42.66	$58.88	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.98 / $24.55	Professional	26	$10.00	$16.98	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $44.67 / $75.86	Professional	TC	$31.62	$44.67	$75.86
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $60.26 / $91.20	Professional		$38.90	$60.26	$91.20
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $15.14 / $21.88	Professional	26	$9.55	$15.14	$21.88
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $46.77 / $67.61	Professional	TC	$29.51	$46.77	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $43.65 / $85.11	Professional		$31.62	$43.65	$85.11
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 $23.44 / $31.62 / $61.66	Professional	TC	$23.44	$31.62	$61.66
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $25.70	Facility		$25.70	$25.70	$25.70
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 $16.60 / $19.50 / $19.50	Facility	TC	$16.60	$19.50	$19.50