Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.49 / $250.28 / $601.67	Facility		$42.49	$250.28	$601.67
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.36 / $11.36 / $20.37	Facility	26	$11.36	$11.36	$20.37
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.12 / $86.02 / $600.24	Facility	TC	$31.12	$86.02	$600.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.72 / $42.49 / $73.63	Professional		$32.72	$42.49	$73.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $10.47 / $20.46	Professional	26	$8.39	$10.47	$20.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.35 / $31.12 / $57.47	Professional	TC	$24.35	$31.12	$57.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.40 / $49.40 / $112.67	Professional		$35.40	$49.40	$112.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $13.33 / $24.41	Professional	26	$7.97	$13.33	$24.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $197.30 / $247.95 / $275.45	Facility		$197.30	$247.95	$275.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.26 / $67.91 / $96.03	Professional		$46.26	$67.91	$96.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $15.20 / $21.49	Professional	26	$10.35	$15.20	$21.49
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $69.39 / $101.86 / $144.05	Professional	50	$69.39	$101.86	$144.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.90 / $52.71 / $74.41	Professional	TC	$35.90	$52.71	$74.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.09 / $248.07 / $521.64	Facility		$170.09	$248.07	$521.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.14 / $88.33 / $145.66	Professional		$59.14	$88.33	$145.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $21.54 / $32.04	Professional	26	$13.49	$21.54	$32.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.17 / $66.43 / $113.29	Professional	TC	$46.17	$66.43	$113.29
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $53.75 / $94.10 / $174.42	Professional		$53.75	$94.10	$174.42
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $11.85 / $19.53 / $36.58	Professional	26	$11.85	$19.53	$36.58
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $42.83 / $81.53 / $135.38	Professional	TC	$42.83	$81.53	$135.38
United Facility/Professional Professional Modifier Low / Median / High Price $45.94 / $58.85 / $108.79	Professional		$45.94	$58.85	$108.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $14.98 / $30.27	Professional	26	$11.70	$14.98	$30.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.61 / $44.34 / $78.76	Professional	TC	$34.61	$44.34	$78.76
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $33.19 / $41.61 / $63.82	Professional		$33.19	$41.61	$63.82
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $10.15 / $14.41	Professional	26	$8.63	$10.15	$14.41
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $24.04 / $31.61 / $44.26	Professional	TC	$24.04	$31.61	$44.26