Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.92 / $316.80 / $513.29	Facility		$49.92	$316.80	$513.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $12.03 / $31.04	Facility	26	$8.32	$12.03	$31.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.60 / $67.68 / $447.42	Facility	TC	$24.60	$67.68	$447.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.58 / $32.92 / $89.79	Professional		$24.58	$32.92	$89.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.67 / $8.28 / $21.62	Professional	26	$6.67	$8.28	$21.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $55.80 / $55.80 / $55.80	Professional	50	$55.80	$55.80	$55.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.04 / $16.46 / $19.89	Professional	52	$12.04	$16.46	$19.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.91 / $24.60 / $67.02	Professional	TC	$17.91	$24.60	$67.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.57 / $37.63 / $85.82	Professional		$28.57	$37.63	$85.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $8.94 / $26.73	Professional	26	$6.16	$8.94	$26.73
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $75.98 / $128.72 / $128.72	Professional	50	$75.98	$128.72	$128.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $150.22 / $188.79 / $209.73	Facility		$150.22	$188.79	$209.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.26 / $51.76 / $73.19	Professional		$35.26	$51.76	$73.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $11.87 / $17.00	Professional	26	$8.09	$11.87	$17.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $52.89 / $77.64 / $109.79	Professional	50	$52.89	$77.64	$109.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.17 / $39.89 / $56.31	Professional	TC	$27.17	$39.89	$56.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.16 / $186.79 / $521.64	Facility		$134.16	$186.79	$521.64
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $152.26 / $152.26 / $152.26	Facility	TC	$152.26	$152.26	$152.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.47 / $62.76 / $112.32	Professional		$45.47	$62.76	$112.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.37 / $16.94 / $25.01	Professional	26	$10.37	$16.94	$25.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.17 / $46.74 / $87.31	Professional	TC	$32.17	$46.74	$87.31
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $71.73 / $132.94	Professional		$40.36	$71.73	$132.94
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.26 / $15.23 / $30.50	Professional	26	$9.26	$15.23	$30.50
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $31.11 / $54.64 / $102.48	Professional	TC	$31.11	$54.64	$102.48
United Facility/Professional Professional Modifier Low / Median / High Price $34.27 / $43.86 / $95.44	Professional		$34.27	$43.86	$95.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $11.73 / $22.33	Professional	26	$8.46	$11.73	$22.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.09 / $34.40 / $110.69	Professional	TC	$26.09	$34.40	$110.69
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $27.31 / $32.59 / $49.22	Professional		$27.31	$32.59	$49.22
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $6.73 / $8.07 / $10.91	Professional	26	$6.73	$8.07	$10.91
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $6.23 / $7.48 / $8.41	Professional	52	$6.23	$7.48	$8.41
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $19.86 / $24.66 / $33.97	Professional	TC	$19.86	$24.66	$33.97