Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $134.90 / $660.69	Facility		$40.74	$134.90	$660.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $16.60 / $20.89	Facility	26	$11.75	$16.60	$20.89
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.84 / $52.48 / $257.04	Facility	TC	$28.84	$52.48	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $40.74 / $100.00	Professional		$32.36	$40.74	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $29.51	Professional	26	$8.91	$12.02	$29.51
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.22 / $186.21 / $204.17	Professional	50	$16.22	$186.21	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.84 / $61.66	Professional	TC	$21.88	$28.84	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $36.31 / $42.66	Professional		$33.11	$36.31	$42.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $8.71 / $22.91	Professional	26	$8.13	$8.71	$22.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	TC	$67.61	$67.61	$67.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $234.42 / $263.03	Facility		$186.21	$234.42	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $64.57 / $85.11	Professional		$41.69	$64.57	$85.11
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 $63.10 / $97.72 / $128.82	Professional	50	$63.10	$97.72	$128.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $47.86 / $63.10	Professional	TC	$30.90	$47.86	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $263.03 / $645.65	Facility		$144.54	$263.03	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $70.79 / $123.03	Professional		$53.70	$70.79	$123.03
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 $39.81 / $54.95 / $93.33	Professional	TC	$39.81	$54.95	$93.33
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $75.86 / $112.20	Professional		$48.98	$75.86	$112.20
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 $36.31 / $56.23 / $83.18	Professional	TC	$36.31	$56.23	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $56.23 / $109.65	Professional		$41.69	$56.23	$109.65
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 $29.51 / $40.74 / $77.62	Professional	TC	$29.51	$40.74	$77.62
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $32.36 / $32.36	Facility		$32.36	$32.36	$32.36
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 $20.89 / $24.55 / $24.55	Facility	TC	$20.89	$24.55	$24.55