Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.92 / $168.81 / $393.24	Facility		$36.92	$168.81	$393.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.63 / $11.55 / $28.35	Facility	26	$7.63	$11.55	$28.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.07 / $51.75 / $168.24	Facility	TC	$20.07	$51.75	$168.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.10 / $27.71 / $76.22	Professional		$20.10	$27.71	$76.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.68 / $7.63 / $19.79	Professional	26	$5.68	$7.63	$19.79
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.05 / $13.65 / $15.94	Professional	52	$10.05	$13.65	$15.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.42 / $20.07 / $54.59	Professional	TC	$14.42	$20.07	$54.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.20 / $21.20 / $29.29	Professional		$21.20	$21.20	$29.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.44 / $7.01 / $23.47	Professional	26	$5.44	$7.01	$23.47
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $59.16 / $59.16 / $59.16	Professional	50	$59.16	$59.16	$59.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.85 / $146.85 / $163.13	Facility		$116.85	$146.85	$163.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.49 / $40.36 / $57.09	Professional		$27.49	$40.36	$57.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.12 / $10.45 / $14.77	Professional	26	$7.12	$10.45	$14.77
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.23 / $60.55 / $85.63	Professional	50	$41.23	$60.55	$85.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.38 / $29.92 / $42.31	Professional	TC	$20.38	$29.92	$42.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.23 / $151.77 / $521.64	Facility		$98.23	$151.77	$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 $35.49 / $56.37 / $87.61	Professional		$35.49	$56.37	$87.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.22 / $14.74 / $21.96	Professional	26	$9.22	$14.74	$21.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.60 / $40.53 / $65.43	Professional	TC	$26.60	$40.53	$65.43
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $29.78 / $51.89 / $103.70	Professional		$29.78	$51.89	$103.70
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $13.28 / $26.85	Professional	26	$8.15	$13.28	$26.85
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $23.33 / $44.45 / $76.84	Professional	TC	$23.33	$44.45	$76.84
United Facility/Professional Professional Modifier Low / Median / High Price $28.15 / $34.86 / $66.25	Professional		$28.15	$34.86	$66.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.63 / $9.94 / $20.70	Professional	26	$7.63	$9.94	$20.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.39 / $26.27 / $50.21	Professional	TC	$20.39	$26.27	$50.21
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $22.12 / $25.84 / $39.02	Professional		$22.12	$25.84	$39.02
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $7.07 / $9.56	Professional	26	$5.90	$7.07	$9.56
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 $16.07 / $18.91 / $26.06	Professional	TC	$16.07	$18.91	$26.06