Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.76 / $293.95 / $592.60	Facility		$50.76	$293.95	$592.60
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 $23.89 / $78.73 / $432.06	Facility	TC	$23.89	$78.73	$432.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.68 / $32.22 / $84.02	Professional		$22.68	$32.22	$84.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.23 / $8.32 / $21.62	Professional	26	$6.23	$8.32	$21.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $54.60 / $54.60 / $54.60	Professional	50	$54.60	$54.60	$54.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.21 / $16.11 / $18.72	Professional	52	$11.21	$16.11	$18.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.45 / $23.90 / $65.88	Professional	TC	$16.45	$23.90	$65.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.75 / $35.19 / $80.27	Professional		$26.75	$35.19	$80.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.93 / $9.03 / $25.64	Professional	26	$5.93	$9.03	$25.64
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $52.79 / $120.40	Professional	50	$38.02	$52.79	$120.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $140.49 / $176.56 / $196.14	Facility		$140.49	$176.56	$196.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.99 / $48.44 / $68.50	Professional		$32.99	$48.44	$68.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.40 / $16.25	Professional	26	$7.76	$11.40	$16.25
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $49.48 / $72.66 / $102.75	Professional	50	$49.48	$72.66	$102.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.23 / $37.04 / $52.28	Professional	TC	$25.23	$37.04	$52.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.22 / $172.19 / $521.64	Facility		$123.22	$172.19	$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 $42.55 / $61.96 / $105.12	Professional		$42.55	$61.96	$105.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.08 / $16.11 / $23.98	Professional	26	$10.08	$16.11	$23.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.17 / $44.74 / $81.14	Professional	TC	$32.17	$44.74	$81.14
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $37.77 / $65.33 / $124.42	Professional		$37.77	$65.33	$124.42
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $14.62 / $29.28	Professional	26	$8.89	$14.62	$29.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $28.88 / $51.33 / $95.13	Professional	TC	$28.88	$51.33	$95.13
United Facility/Professional Professional Modifier Low / Median / High Price $32.56 / $42.60 / $77.59	Professional		$32.56	$42.60	$77.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $11.38 / $38.40	Professional	26	$8.46	$11.38	$38.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.78 / $31.73 / $56.19	Professional	TC	$24.78	$31.73	$56.19
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $30.55 / $46.15	Professional		$25.37	$30.55	$46.15
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $6.44 / $7.73 / $10.45	Professional	26	$6.44	$7.73	$10.45
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 $18.25 / $22.96 / $31.65	Professional	TC	$18.25	$22.96	$31.65