Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.39 / $199.43 / $521.05	Facility		$28.39	$199.43	$521.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.98 / $11.55 / $28.35	Facility	26	$7.98	$11.55	$28.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $69.22 / $371.34	Facility	TC	$20.42	$69.22	$371.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.10 / $28.40 / $75.38	Professional		$20.10	$28.40	$75.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.26 / $7.98 / $20.79	Professional	26	$6.26	$7.98	$20.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.84 / $20.42 / $57.37	Professional	TC	$13.84	$20.42	$57.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $69.19 / $69.19	Professional		$23.10	$69.19	$69.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $9.57 / $24.56	Professional	26	$5.67	$9.57	$24.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.02 / $152.09 / $168.96	Facility		$121.02	$152.09	$168.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.46 / $41.79 / $59.09	Professional		$28.46	$41.79	$59.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $10.92 / $15.44	Professional	26	$7.44	$10.92	$15.44
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.69 / $62.68 / $88.64	Professional	50	$42.69	$62.68	$88.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.03 / $30.87 / $43.57	Professional	TC	$21.03	$30.87	$43.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $101.35 / $143.01 / $521.64	Facility		$101.35	$143.01	$521.64
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $149.44 / $149.44 / $149.44	Facility	TC	$149.44	$149.44	$149.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.32 / $57.65 / $89.72	Professional		$36.32	$57.65	$89.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $15.57 / $22.99	Professional	26	$9.71	$15.57	$22.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.02 / $41.23 / $66.73	Professional	TC	$27.02	$41.23	$66.73
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $32.59 / $56.37 / $107.35	Professional		$32.59	$56.37	$107.35
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $14.74 / $28.07	Professional	26	$8.52	$14.74	$28.07
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $24.07 / $42.78 / $79.29	Professional	TC	$24.07	$42.78	$79.29
United Facility/Professional Professional Modifier Low / Median / High Price $29.26 / $37.86 / $60.36	Professional		$29.26	$37.86	$60.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.63 / $10.88 / $22.68	Professional	26	$7.63	$10.88	$22.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $35.70 / $72.83	Professional	TC	$24.23	$35.70	$72.83
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $22.49 / $26.85 / $40.54	Professional		$22.49	$26.85	$40.54
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $6.48 / $7.62 / $10.50	Professional	26	$6.48	$7.62	$10.50
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $15.47 / $19.25 / $26.53	Professional	TC	$15.47	$19.25	$26.53