Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $251.19 / $630.96	Facility		$42.66	$251.19	$630.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $12.88 / $33.88	Facility	26	$9.77	$12.88	$33.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.54 / $48.98 / $275.42	Facility	TC	$27.54	$48.98	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $35.48 / $104.71	Professional		$9.12	$35.48	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $16.22 / $40.74	Professional	26	$7.94	$16.22	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.88 / $69.18 / $288.40	Professional	50	$33.88	$69.18	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.11 / $87.10	Professional	TC	$22.91	$33.11	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $34.67 / $61.66	Professional		$26.30	$34.67	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $11.22 / $14.13	Professional	26	$6.61	$11.22	$14.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $67.61 / $91.20	Professional	50	$45.71	$67.61	$91.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $25.70 / $36.31	Professional	TC	$21.38	$25.70	$36.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $239.88 / $269.15	Facility		$190.55	$239.88	$269.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $63.10 / $83.18	Professional		$42.66	$63.10	$83.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.13 / $20.42	Professional	26	$9.33	$14.13	$20.42
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $63.10 / $95.50 / $125.89	Professional	50	$63.10	$95.50	$125.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $48.98 / $66.07	Professional	TC	$33.11	$48.98	$66.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $257.04 / $524.81	Facility		$147.91	$257.04	$524.81
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	TC	$169.82	$169.82	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $66.07 / $123.03	Professional		$48.98	$66.07	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $18.20 / $26.92	Professional	26	$10.96	$18.20	$26.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $50.12 / $95.50	Professional	TC	$35.48	$50.12	$95.50
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $77.62 / $117.49	Professional		$48.98	$77.62	$117.49
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $16.98 / $25.12	Professional	26	$10.72	$16.98	$25.12
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $58.88 / $87.10	Professional	TC	$38.02	$58.88	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $54.95 / $107.15	Professional		$35.48	$54.95	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.59 / $24.55	Professional	26	$8.71	$12.59	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $42.66 / $79.43	Professional	TC	$26.30	$42.66	$79.43
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 $5.75 / $6.76 / $6.76	Facility	26	$5.75	$6.76	$6.76
Well Sense Facility/Professional Facility Modifier TC Low / Median / High Price $21.38 / $25.12 / $25.12	Facility	TC	$21.38	$25.12	$25.12