Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $213.80 / $537.03	Facility		$38.90	$213.80	$537.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $12.02 / $30.90	Facility	26	$8.32	$12.02	$30.90
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.50 / $56.23 / $389.05	Facility	TC	$19.50	$56.23	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $27.54 / $93.33	Professional		$8.32	$27.54	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $15.14 / $34.67	Professional	26	$6.92	$15.14	$34.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.90 / $56.23 / $275.42	Professional	50	$30.90	$56.23	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $70.79	Professional	TC	$16.98	$25.12	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $25.70 / $46.77	Professional		$23.44	$25.70	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $9.77 / $24.55	Professional	26	$5.75	$9.77	$24.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $15.14 / $15.14	Professional	TC	$15.14	$15.14	$15.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $177.83 / $199.53	Facility		$141.25	$177.83	$199.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $50.12 / $66.07	Professional		$31.62	$50.12	$66.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.02 / $17.38	Professional	26	$7.76	$12.02	$17.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $74.13 / $97.72	Professional	50	$46.77	$74.13	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $37.15 / $50.12	Professional	TC	$23.44	$37.15	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $204.17 / $524.81	Facility		$112.20	$204.17	$524.81
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	TC	$147.91	$147.91	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $51.29 / $95.50	Professional		$38.02	$51.29	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.49 / $22.91	Professional	26	$9.33	$15.49	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.90 / $72.44	Professional	TC	$28.18	$38.90	$72.44
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $56.23 / $87.10	Professional		$35.48	$56.23	$87.10
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.80 / $19.95	Professional	26	$8.91	$13.80	$19.95
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $43.65 / $63.10	Professional	TC	$27.54	$43.65	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $41.69 / $79.43	Professional		$30.90	$41.69	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.72 / $21.38	Professional	26	$8.32	$10.72	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.90 / $56.23	Professional	TC	$21.38	$30.90	$56.23
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Facility		$25.12	$25.12	$25.12
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $4.90 / $5.75 / $5.75	Facility	26	$4.90	$5.75	$5.75
Well Sense Facility/Professional Facility Modifier TC Low / Median / High Price $16.22 / $19.05 / $19.05	Facility	TC	$16.22	$19.05	$19.05