Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.39 / $212.66 / $489.65	Facility		$39.39	$212.66	$489.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.09 / $12.11 / $31.04	Facility	26	$9.09	$12.11	$31.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.80 / $64.08 / $452.30	Facility	TC	$21.80	$64.08	$452.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.84 / $30.92 / $82.95	Professional		$22.84	$30.92	$82.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.96 / $8.55 / $23.76	Professional	26	$6.96	$8.55	$23.76
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.24 / $52.24 / $52.24	Professional	50	$52.24	$52.24	$52.24
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.42 / $15.46 / $19.09	Professional	52	$11.42	$15.46	$19.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.87 / $21.81 / $59.10	Professional	TC	$15.87	$21.81	$59.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.33 / $57.11 / $80.29	Professional		$25.33	$57.11	$80.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $9.99 / $25.68	Professional	26	$5.90	$9.99	$25.68
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $40.11 / $40.61 / $120.44	Professional	50	$40.11	$40.61	$120.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $140.53 / $176.61 / $196.20	Facility		$140.53	$176.61	$196.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.99 / $48.44 / $68.50	Professional		$32.99	$48.44	$68.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.40 / $16.12	Professional	26	$7.76	$11.40	$16.12
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $49.48 / $72.66 / $102.75	Professional	50	$49.48	$72.66	$102.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.23 / $37.04 / $52.38	Professional	TC	$25.23	$37.04	$52.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.22 / $185.14 / $521.64	Facility		$123.22	$185.14	$521.64
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $149.44 / $149.44 / $149.44	Facility	TC	$149.44	$149.44	$149.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.57 / $60.36 / $105.15	Professional		$42.57	$60.36	$105.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $16.23 / $24.27	Professional	26	$10.15	$16.23	$24.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.49 / $43.43 / $81.14	Professional	TC	$31.49	$43.43	$81.14
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $37.77 / $65.33 / $124.42	Professional		$37.77	$65.33	$124.42
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $14.62 / $29.28	Professional	26	$8.89	$14.62	$29.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $28.88 / $51.33 / $95.13	Professional	TC	$28.88	$51.33	$95.13
United Facility/Professional Professional Modifier Low / Median / High Price $33.15 / $42.07 / $79.79	Professional		$33.15	$42.07	$79.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $10.88 / $21.45	Professional	26	$8.46	$10.88	$21.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.69 / $31.56 / $62.04	Professional	TC	$24.69	$31.56	$62.04
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $26.76 / $31.26 / $47.20	Professional		$26.76	$31.26	$47.20
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $7.97 / $10.50	Professional	26	$6.52	$7.97	$10.50
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $6.15 / $7.38 / $8.30	Professional	52	$6.15	$7.38	$8.30
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $23.64 / $32.58	Professional	TC	$19.30	$23.64	$32.58