Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $331.13 / $512.86	Facility		$50.12	$331.13	$512.86
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 $24.55 / $67.61 / $446.68	Facility	TC	$24.55	$67.61	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $30.20 / $95.50	Professional		$8.71	$30.20	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $15.14 / $40.74	Professional	26	$7.24	$15.14	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $91.20 / $288.40	Professional	50	$36.31	$91.20	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $79.43	Professional	TC	$19.05	$28.84	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $28.84 / $64.57	Professional		$23.99	$28.84	$64.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.76 / $26.92	Professional	26	$6.17	$7.76	$26.92
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $56.23 / $56.23 / $134.90	Professional	50	$56.23	$56.23	$134.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $20.42 / $41.69	Professional	TC	$18.62	$20.42	$41.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $208.93 / $234.42	Facility		$165.96	$208.93	$234.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $57.54 / $75.86	Professional		$37.15	$57.54	$75.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.88 / $18.62	Professional	26	$8.32	$12.88	$18.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $56.23 / $85.11 / $112.20	Professional	50	$56.23	$85.11	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $43.65 / $57.54	Professional	TC	$28.84	$43.65	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $239.88 / $524.81	Facility		$134.90	$239.88	$524.81
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	TC	$151.36	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $58.88 / $112.20	Professional		$43.65	$58.88	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.98 / $24.55	Professional	26	$10.00	$16.98	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $44.67 / $87.10	Professional	TC	$32.36	$44.67	$87.10
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $70.79 / $104.71	Professional		$42.66	$70.79	$104.71
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $15.14 / $22.39	Professional	26	$9.55	$15.14	$22.39
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $50.12 / $75.86	Professional	TC	$33.11	$50.12	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $93.33	Professional		$32.36	$47.86	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.75 / $22.39	Professional	26	$8.51	$11.75	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $37.15 / $69.18	Professional	TC	$22.39	$37.15	$69.18
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $29.51 / $29.51	Facility		$29.51	$29.51	$29.51
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $5.25 / $6.31 / $6.31	Facility	26	$5.25	$6.31	$6.31
Well Sense Facility/Professional Facility Modifier TC Low / Median / High Price $19.50 / $22.91 / $22.91	Facility	TC	$19.50	$22.91	$22.91