Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $239.88 / $512.86	Facility		$38.90	$239.88	$512.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $11.48 / $28.18	Facility	26	$7.94	$11.48	$28.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $51.29 / $354.81	Facility	TC	$20.42	$51.29	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $26.30 / $81.28	Professional		$8.32	$26.30	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $14.45 / $35.48	Professional	26	$6.76	$14.45	$35.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.88 / $141.25 / $281.84	Professional	50	$33.88	$141.25	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $21.88 / $67.61	Professional	TC	$15.85	$21.88	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $28.84 / $95.50	Professional		$18.62	$28.84	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $1.55 / $7.76 / $25.12	Professional	26	$1.55	$7.76	$25.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $27.54 / $27.54	Professional	TC	$27.54	$27.54	$27.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $162.18 / $181.97	Facility		$131.83	$162.18	$181.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $45.71 / $60.26	Professional		$28.84	$45.71	$60.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.02 / $17.38	Professional	26	$7.76	$12.02	$17.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $69.18 / $91.20	Professional	50	$43.65	$69.18	$91.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.11 / $44.67	Professional	TC	$21.38	$33.11	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $181.97 / $524.81	Facility		$102.33	$181.97	$524.81
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 / $48.98 / $87.10	Professional		$36.31	$48.98	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.49 / $22.91	Professional	26	$9.33	$15.49	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $35.48 / $66.07	Professional	TC	$26.30	$35.48	$66.07
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $56.23 / $81.28	Professional		$33.11	$56.23	$81.28
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.80 / $20.42	Professional	26	$8.91	$13.80	$20.42
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $39.81 / $56.23	Professional	TC	$24.55	$39.81	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $38.90 / $72.44	Professional		$29.51	$38.90	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.22 / $21.38	Professional	26	$7.59	$11.22	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.18 / $51.29	Professional	TC	$20.89	$28.18	$51.29
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $22.91 / $22.91	Facility		$22.91	$22.91	$22.91
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $4.90 / $5.75 / $5.75	Facility	26	$4.90	$5.75	$5.75
Well Sense Facility/Professional Facility Modifier TC Low / Median / High Price $14.79 / $17.38 / $17.38	Facility	TC	$14.79	$17.38	$17.38