Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $295.12 / $602.56	Facility		$50.12	$295.12	$602.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $11.48 / $24.55	Facility	26	$11.48	$11.48	$24.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.90 / $85.11 / $602.56	Facility	TC	$30.90	$85.11	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $38.02 / $134.90	Professional		$10.47	$38.02	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.49 / $41.69	Professional	26	$9.12	$13.49	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.02 / $117.49	Professional	TC	$26.92	$38.02	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $38.02 / $72.44	Professional		$31.62	$38.02	$72.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.75 / $33.88	Professional	26	$8.32	$11.75	$33.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $26.92 / $57.54	Professional	TC	$25.12	$26.92	$57.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $275.42 / $309.03	Facility		$218.78	$275.42	$309.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $74.13 / $97.72	Professional		$48.98	$74.13	$97.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $16.60 / $23.99	Professional	26	$10.72	$16.60	$23.99
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $112.20 / $147.91	Professional	50	$72.44	$112.20	$147.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $57.54 / $75.86	Professional	TC	$38.02	$57.54	$75.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $257.04 / $524.81	Facility		$169.82	$257.04	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $77.62 / $141.25	Professional		$58.88	$77.62	$141.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $21.38 / $31.62	Professional	26	$12.88	$21.38	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $58.88 / $112.20	Professional	TC	$44.67	$58.88	$112.20
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $91.20 / $134.90	Professional		$57.54	$91.20	$134.90
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $19.50 / $28.18	Professional	26	$12.30	$19.50	$28.18
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $64.57 / $102.33	Professional	TC	$43.65	$64.57	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $64.57 / $123.03	Professional		$45.71	$64.57	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $15.14 / $28.84	Professional	26	$11.48	$15.14	$28.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $48.98 / $91.20	Professional	TC	$33.11	$48.98	$91.20
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $37.15 / $37.15	Facility		$37.15	$37.15	$37.15
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $7.94 / $7.94	Facility	26	$6.76	$7.94	$7.94
Well Sense Facility/Professional Facility Modifier TC Low / Median / High Price $24.55 / $28.84 / $28.84	Facility	TC	$24.55	$28.84	$28.84