Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.63 / $9.51 / $24.43	Facility	26	$6.63	$9.51	$24.43
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.19 / $78.73 / $668.11	Facility	TC	$21.19	$78.73	$668.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.58 / $31.93 / $84.76	Professional		$24.58	$31.93	$84.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.21 / $6.61 / $17.29	Professional	26	$5.21	$6.61	$17.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.24 / $15.97 / $20.19	Professional	52	$12.24	$15.97	$20.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.37 / $25.30 / $67.53	Professional	TC	$19.37	$25.30	$67.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $39.76 / $90.68	Professional		$28.45	$39.76	$90.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.83 / $8.32 / $21.37	Professional	26	$4.83	$8.32	$21.37
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $63.71 / $63.71 / $136.02	Professional	50	$63.71	$63.71	$136.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $54.61 / $77.22	Professional		$37.20	$54.61	$77.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.47 / $9.50 / $13.43	Professional	26	$6.47	$9.50	$13.43
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $55.80 / $81.91 / $115.84	Professional	50	$55.80	$81.91	$115.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.73 / $45.12 / $63.69	Professional	TC	$30.73	$45.12	$63.69
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $121.69 / $121.69 / $121.69	Facility	TC	$121.69	$121.69	$121.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.25 / $62.95 / $117.60	Professional		$44.25	$62.95	$117.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $13.39 / $20.00	Professional	26	$8.10	$13.39	$20.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $52.24 / $97.60	Professional	TC	$32.79	$52.24	$97.60
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $42.58 / $73.65 / $140.26	Professional		$42.58	$73.65	$140.26
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $12.19 / $24.41	Professional	26	$7.41	$12.19	$24.41
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $35.18 / $62.52 / $115.89	Professional	TC	$35.18	$62.52	$115.89
United Facility/Professional Professional Modifier Low / Median / High Price $26.81 / $46.41 / $78.44	Professional		$26.81	$46.41	$78.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $9.36 / $19.02	Professional	26	$6.45	$9.36	$19.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.37 / $36.08 / $63.89	Professional	TC	$22.37	$36.08	$63.89
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $27.75 / $33.36 / $50.40	Professional		$27.75	$33.36	$50.40
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $5.39 / $6.34 / $8.74	Professional	26	$5.39	$6.34	$8.74
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $4.88 / $5.86 / $6.59	Professional	52	$4.88	$5.86	$6.59
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $21.80 / $27.03 / $37.26	Professional	TC	$21.80	$27.03	$37.26