Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.92 / $96.23 / $289.29	Facility		$36.92	$96.23	$289.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.98 / $15.27 / $28.35	Facility	26	$7.98	$15.27	$28.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.07 / $67.88 / $391.58	Facility	TC	$20.07	$67.88	$391.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $28.05 / $77.20	Professional		$20.39	$28.05	$77.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.26 / $7.48 / $20.79	Professional	26	$6.26	$7.48	$20.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.52 / $47.52 / $47.52	Professional	50	$47.52	$47.52	$47.52
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.10 / $14.03 / $17.32	Professional	52	$10.10	$14.03	$17.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $20.07 / $56.40	Professional	TC	$14.13	$20.07	$56.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.22 / $6.47 / $18.28	Professional	26	$6.22	$6.47	$18.28
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $110.94 / $110.94 / $110.94	Professional	50	$110.94	$110.94	$110.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $129.41 / $162.63 / $180.66	Facility		$129.41	$162.63	$180.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.41 / $44.64 / $63.12	Professional		$30.41	$44.64	$63.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.40 / $16.12	Professional	26	$7.76	$11.40	$16.12
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.61 / $66.95 / $94.69	Professional	50	$45.61	$66.95	$94.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.64 / $33.24 / $46.92	Professional	TC	$22.64	$33.24	$46.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.16 / $163.44 / $640.01	Facility		$109.16	$163.44	$640.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $141.15 / $141.15 / $141.15	Facility	TC	$141.15	$141.15	$141.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.24 / $56.37 / $96.92	Professional		$39.24	$56.37	$96.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.76 / $16.07 / $24.01	Professional	26	$9.76	$16.07	$24.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $40.72 / $72.70	Professional	TC	$29.51	$40.72	$72.70
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $34.81 / $62.52 / $114.67	Professional		$34.81	$62.52	$114.67
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $15.38 / $29.28	Professional	26	$8.89	$15.38	$29.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $25.92 / $44.84 / $85.38	Professional	TC	$25.92	$44.84	$85.38
United Facility/Professional Professional Modifier Low / Median / High Price $30.93 / $38.02 / $59.30	Professional		$30.93	$38.02	$59.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.63 / $11.23 / $22.67	Professional	26	$7.63	$11.23	$22.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.22 / $28.47 / $49.24	Professional	TC	$22.22	$28.47	$49.24
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $22.82 / $28.21 / $42.60	Professional		$22.82	$28.21	$42.60
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 52 Low / Median / High Price $5.75 / $6.90 / $7.76	Professional	52	$5.75	$6.90	$7.76
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $15.87 / $20.59 / $28.38	Professional	TC	$15.87	$20.59	$28.38