Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.97 / $232.18 / $561.00	Facility		$38.97	$232.18	$561.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $11.58 / $31.04	Facility	26	$8.32	$11.58	$31.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.71 / $66.50 / $389.48	Facility	TC	$19.71	$66.50	$389.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.65 / $28.04 / $77.06	Professional		$20.65	$28.04	$77.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $7.78 / $21.62	Professional	26	$6.52	$7.78	$21.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,164.00 / $1,164.00 / $1,164.00	Professional	50	$1,164.00	$1,164.00	$1,164.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $19.72 / $55.43	Professional	TC	$14.13	$19.72	$55.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.63 / $44.11 / $74.73	Professional		$23.63	$44.11	$74.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $9.57 / $24.56	Professional	26	$5.70	$9.57	$24.56
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $35.44 / $35.44 / $35.44	Professional	50	$35.44	$35.44	$35.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $130.80 / $164.38 / $182.61	Facility		$130.80	$164.38	$182.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $45.12 / $63.80	Professional		$30.73	$45.12	$63.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $10.92 / $15.44	Professional	26	$7.44	$10.92	$15.44
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $46.09 / $67.68 / $95.71	Professional	50	$46.09	$67.68	$95.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.29 / $34.19 / $48.35	Professional	TC	$23.29	$34.19	$48.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.29 / $166.36 / $521.64	Facility		$112.29	$166.36	$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 $39.24 / $59.56 / $96.92	Professional		$39.24	$59.56	$96.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $15.57 / $23.23	Professional	26	$9.71	$15.57	$23.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.93 / $42.15 / $73.94	Professional	TC	$29.93	$42.15	$73.94
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $35.18 / $62.52 / $115.89	Professional		$35.18	$62.52	$115.89
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $13.17 / $23.91	Professional	26	$8.52	$13.17	$23.91
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $26.66 / $47.28 / $87.82	Professional	TC	$26.66	$47.28	$87.82
United Facility/Professional Professional Modifier Low / Median / High Price $29.14 / $39.82 / $78.95	Professional		$29.14	$39.82	$78.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $10.72 / $36.82	Professional	26	$8.46	$10.72	$36.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.95 / $29.56 / $56.14	Professional	TC	$22.95	$29.56	$56.14
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $24.44 / $28.55 / $43.11	Professional		$24.44	$28.55	$43.11
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $6.23 / $7.73 / $10.17	Professional	26	$6.23	$7.73	$10.17
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $17.82 / $21.27 / $29.32	Professional	TC	$17.82	$21.27	$29.32