Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.28 / $263.95 / $480.87	Facility		$33.28	$263.95	$480.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.58 / $9.58 / $17.20	Facility	26	$9.58	$9.58	$17.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.69 / $33.85 / $440.44	Facility	TC	$23.69	$33.85	$440.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.59 / $33.28 / $59.92	Professional		$25.59	$33.28	$59.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.07 / $8.83 / $18.53	Professional	26	$7.07	$8.83	$18.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.52 / $23.69 / $48.69	Professional	TC	$18.52	$23.69	$48.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.58 / $36.92 / $84.21	Professional		$26.58	$36.92	$84.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.48 / $8.26 / $27.78	Professional	26	$6.48	$8.26	$27.78
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $126.31 / $126.31 / $126.31	Professional	50	$126.31	$126.31	$126.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.40 / $185.25 / $205.79	Facility		$147.40	$185.25	$205.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.61 / $50.81 / $71.84	Professional		$34.61	$50.81	$71.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $12.35 / $17.46	Professional	26	$8.41	$12.35	$17.46
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $51.91 / $76.20 / $107.78	Professional	50	$51.91	$76.20	$107.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.20 / $38.47 / $54.40	Professional	TC	$26.20	$38.47	$54.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.35 / $189.84 / $521.64	Facility		$126.35	$189.84	$521.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.21 / $69.23 / $109.20	Professional		$44.21	$69.23	$109.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.99 / $17.61 / $26.00	Professional	26	$10.99	$17.61	$26.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.68 / $49.35 / $83.20	Professional	TC	$33.68	$49.35	$83.20
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $70.41 / $130.51	Professional		$39.61	$70.41	$130.51
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $15.84 / $31.72	Professional	26	$9.63	$15.84	$31.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $29.99 / $52.67 / $98.79	Professional	TC	$29.99	$52.67	$98.79
United Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $45.51 / $84.33	Professional		$34.29	$45.51	$84.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $12.19 / $24.15	Professional	26	$9.44	$12.19	$24.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.19 / $33.14 / $64.01	Professional	TC	$26.19	$33.14	$64.01
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $27.23 / $32.21 / $48.65	Professional		$27.23	$32.21	$48.65
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $8.23 / $12.16	Professional	26	$7.00	$8.23	$12.16
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $19.28 / $23.98 / $33.04	Professional	TC	$19.28	$23.98	$33.04