Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.47 / $16.01 / $40.29	Facility	26	$11.47	$16.01	$40.29
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.21 / $101.71 / $550.72	Facility	TC	$31.21	$101.71	$550.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.25 / $42.68 / $116.37	Professional		$31.25	$42.68	$116.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.68 / $11.47 / $29.88	Professional	26	$8.68	$11.47	$29.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $72.23 / $72.23 / $72.23	Professional	50	$72.23	$72.23	$72.23
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.18 / $21.34 / $24.96	Professional	52	$15.18	$21.34	$24.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $31.22 / $85.45	Professional	TC	$22.57	$31.22	$85.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $49.05 / $111.86	Professional		$35.15	$49.05	$111.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.90 / $35.34	Professional	26	$8.51	$12.90	$35.34
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.73 / $167.80 / $167.80	Professional	50	$52.73	$167.80	$167.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.95 / $30.95 / $52.79	Professional	TC	$30.95	$30.95	$52.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.93 / $67.44 / $95.37	Professional		$45.93	$67.44	$95.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.67 / $15.67 / $22.16	Professional	26	$10.67	$15.67	$22.16
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $68.89 / $101.16 / $143.06	Professional	50	$68.89	$101.16	$143.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.26 / $51.76 / $73.06	Professional	TC	$35.26	$51.76	$73.06
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $182.32 / $182.32 / $182.32	Facility	TC	$182.32	$182.32	$182.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.55 / $77.72 / $144.63	Professional		$55.55	$77.72	$144.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.39 / $21.92 / $33.07	Professional	26	$13.39	$21.92	$33.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.36 / $59.95 / $111.21	Professional	TC	$40.36	$59.95	$111.21
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $52.58 / $93.45 / $173.20	Professional		$52.58	$93.45	$173.20
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $12.22 / $21.14 / $40.25	Professional	26	$12.22	$21.14	$40.25
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $40.36 / $71.73 / $132.94	Professional	TC	$40.36	$71.73	$132.94
United Facility/Professional Professional Modifier Low / Median / High Price $41.77 / $56.98 / $102.71	Professional		$41.77	$56.98	$102.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.71 / $14.98 / $51.26	Professional	26	$10.71	$14.98	$51.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.76 / $42.69 / $95.44	Professional	TC	$31.76	$42.69	$95.44
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $34.59 / $40.90 / $61.78	Professional		$34.59	$40.90	$61.78
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $10.25 / $13.99	Professional	26	$8.63	$10.25	$13.99
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $7.52 / $7.52 / $9.02	Professional	52	$7.52	$7.52	$9.02
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $25.02 / $30.75 / $42.39	Professional	TC	$25.02	$30.75	$42.39