Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.75 / $59.97 / $316.35	Facility		$28.75	$59.97	$316.35
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.98 / $11.55 / $28.35	Facility	26	$7.98	$11.55	$28.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.76 / $39.58 / $383.69	Facility	TC	$20.76	$39.58	$383.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.26 / $28.75 / $78.61	Professional		$21.26	$28.75	$78.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.26 / $7.48 / $20.79	Professional	26	$6.26	$7.48	$20.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.70 / $48.70 / $48.70	Professional	50	$48.70	$48.70	$48.70
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.63 / $14.38 / $18.11	Professional	52	$10.63	$14.38	$18.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.00 / $20.77 / $56.85	Professional	TC	$15.00	$20.77	$56.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $25.18 / $25.18	Professional		$23.87	$25.18	$25.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.98 / $6.21 / $17.55	Professional	26	$5.98	$6.21	$17.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $132.19 / $166.12 / $184.55	Facility		$132.19	$166.12	$184.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.05 / $45.59 / $64.47	Professional		$31.05	$45.59	$64.47
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 $46.57 / $68.38 / $96.71	Professional	50	$46.57	$68.38	$96.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.61 / $34.67 / $49.03	Professional	TC	$23.61	$34.67	$49.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.41 / $173.41 / $521.64	Facility		$115.41	$173.41	$521.64
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $141.15 / $141.15 / $141.15	Facility	TC	$141.15	$141.15	$141.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.07 / $56.37 / $98.98	Professional		$40.07	$56.37	$98.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $15.64 / $22.99	Professional	26	$9.71	$15.64	$22.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.73 / $40.72 / $76.00	Professional	TC	$29.73	$40.72	$76.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $33.63 / $59.57 / $117.11	Professional		$33.63	$59.57	$117.11
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $13.88 / $28.07	Professional	26	$8.52	$13.88	$28.07
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $27.03 / $46.76 / $89.04	Professional	TC	$27.03	$46.76	$89.04
United Facility/Professional Professional Modifier Low / Median / High Price $30.93 / $41.73 / $81.90	Professional		$30.93	$41.73	$81.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.63 / $11.26 / $22.81	Professional	26	$7.63	$11.26	$22.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.68 / $32.84 / $82.86	Professional	TC	$23.68	$32.84	$82.86
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $25.31 / $29.56 / $44.65	Professional		$25.31	$29.56	$44.65
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $6.48 / $7.62 / $10.50	Professional	26	$6.48	$7.62	$10.50
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $5.75 / $6.90 / $7.76	Professional	52	$5.75	$6.90	$7.76
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $18.55 / $21.95 / $30.25	Professional	TC	$18.55	$21.95	$30.25