Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.39 / $135.69 / $593.28	Facility		$42.39	$135.69	$593.28
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $12.96 / $33.69	Facility	26	$9.77	$12.96	$33.69
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.39 / $49.18 / $526.99	Facility	TC	$27.39	$49.18	$526.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.88 / $37.17 / $99.61	Professional		$26.88	$37.17	$99.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $9.34 / $25.57	Professional	26	$7.22	$9.34	$25.57
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $62.88 / $62.88 / $62.88	Professional	50	$62.88	$62.88	$62.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.44 / $18.59 / $22.29	Professional	52	$13.44	$18.59	$22.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.66 / $27.39 / $74.14	Professional	TC	$19.66	$27.39	$74.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.23 / $42.14 / $96.11	Professional		$30.23	$42.14	$96.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.65 / $10.97 / $28.90	Professional	26	$6.65	$10.97	$28.90
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $45.34 / $47.95 / $85.09	Professional	50	$45.34	$47.95	$85.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $168.30 / $211.51 / $234.97	Facility		$168.30	$211.51	$234.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.46 / $57.94 / $81.93	Professional		$39.46	$57.94	$81.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $12.82 / $18.13	Professional	26	$8.73	$12.82	$18.13
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $59.19 / $86.91 / $122.90	Professional	50	$59.19	$86.91	$122.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.73 / $45.12 / $63.80	Professional	TC	$30.73	$45.12	$63.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.22 / $215.97 / $521.64	Facility		$148.22	$215.97	$521.64
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $168.49 / $168.49 / $168.49	Facility	TC	$168.49	$168.49	$168.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.76 / $68.19 / $125.66	Professional		$49.76	$68.19	$125.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.21 / $18.10 / $27.17	Professional	26	$11.21	$18.10	$27.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.65 / $52.80 / $98.63	Professional	TC	$35.65	$52.80	$98.63
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $45.18 / $80.29 / $148.83	Professional		$45.18	$80.29	$148.83
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.45 / $30.86	Professional	26	$10.00	$16.45	$30.86
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $35.18 / $62.52 / $115.89	Professional	TC	$35.18	$62.52	$115.89
United Facility/Professional Professional Modifier Low / Median / High Price $37.32 / $59.52 / $114.76	Professional		$37.32	$59.52	$114.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.81 / $12.25 / $26.36	Professional	26	$8.81	$12.25	$26.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.51 / $38.72 / $68.53	Professional	TC	$28.51	$38.72	$68.53
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $31.35 / $36.61 / $55.30	Professional		$31.35	$36.61	$55.30
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $7.28 / $8.64 / $11.82	Professional	26	$7.28	$8.64	$11.82
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $6.74 / $8.09 / $9.10	Professional	52	$6.74	$8.09	$9.10
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $23.41 / $28.04 / $38.65	Professional	TC	$23.41	$28.04	$38.65