Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.68 / $375.70 / $589.50	Facility		$40.68	$375.70	$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 $24.25 / $45.03 / $447.42	Facility	TC	$24.25	$45.03	$447.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.85 / $32.57 / $88.96	Professional		$23.85	$32.57	$88.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $8.32 / $21.62	Professional	26	$6.52	$8.32	$21.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $55.20 / $55.20 / $55.20	Professional	50	$55.20	$55.20	$55.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $24.25 / $67.02	Professional	TC	$17.32	$24.25	$67.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.35 / $52.05 / $122.23	Professional		$29.35	$52.05	$122.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $9.28 / $26.73	Professional	26	$6.16	$9.28	$26.73
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.67 / $78.08 / $132.29	Professional	50	$41.67	$78.08	$132.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.40 / $194.04 / $215.55	Facility		$154.40	$194.04	$215.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.22 / $53.19 / $75.22	Professional		$36.22	$53.19	$75.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $11.87 / $17.00	Professional	26	$8.09	$11.87	$17.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $54.34 / $79.78 / $112.83	Professional	50	$54.34	$79.78	$112.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.14 / $41.32 / $58.33	Professional	TC	$28.14	$41.32	$58.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.16 / $189.70 / $521.64	Facility		$134.16	$189.70	$521.64
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $152.26 / $152.26 / $152.26	Facility	TC	$152.26	$152.26	$152.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.78 / $61.96 / $114.38	Professional		$45.78	$61.96	$114.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.37 / $16.80 / $25.01	Professional	26	$10.37	$16.80	$25.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.17 / $47.84 / $89.36	Professional	TC	$32.17	$47.84	$89.36
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $41.47 / $73.70 / $136.61	Professional		$41.47	$73.70	$136.61
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.26 / $16.02 / $30.50	Professional	26	$9.26	$16.02	$30.50
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $32.22 / $57.26 / $106.14	Professional	TC	$32.22	$57.26	$106.14
United Facility/Professional Professional Modifier Low / Median / High Price $34.08 / $45.40 / $79.73	Professional		$34.08	$45.40	$79.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $11.86 / $22.33	Professional	26	$8.46	$11.86	$22.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.62 / $34.25 / $59.53	Professional	TC	$25.62	$34.25	$59.53
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $26.99 / $32.59 / $49.22	Professional		$26.99	$32.59	$49.22
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 $19.54 / $24.66 / $33.97	Professional	TC	$19.54	$24.66	$33.97