Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $338.84 / $588.84	Facility		$53.70	$338.84	$588.84
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 $23.99 / $63.10 / $416.87	Facility	TC	$23.99	$63.10	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $29.51 / $97.72	Professional		$7.94	$29.51	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $14.13 / $40.74	Professional	26	$6.92	$14.13	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $114.82 / $218.78	Professional	50	$34.67	$114.82	$218.78
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $3.80 / $3.80 / $3.80	Professional	52	$3.80	$3.80	$3.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.84 / $85.11	Professional	TC	$18.20	$28.84	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.92 / $53.70	Professional		$21.38	$26.92	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $7.76 / $12.30	Professional	26	$6.03	$7.76	$12.30
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $38.90 / $120.23	Professional	50	$38.02	$38.90	$120.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $22.91 / $38.02	Professional	TC	$16.22	$22.91	$38.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $190.55 / $213.80	Facility		$154.88	$190.55	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $53.70 / $70.79	Professional		$33.88	$53.70	$70.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.59 / $18.20	Professional	26	$7.94	$12.59	$18.20
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $51.29 / $79.43 / $104.71	Professional	50	$51.29	$79.43	$104.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $39.81 / $53.70	Professional	TC	$26.30	$39.81	$53.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $223.87 / $524.81	Facility		$123.03	$223.87	$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 $40.74 / $54.95 / $102.33	Professional		$40.74	$54.95	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $16.22 / $23.44	Professional	26	$9.55	$16.22	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $41.69 / $79.43	Professional	TC	$31.62	$41.69	$79.43
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $61.66 / $93.33	Professional		$38.90	$61.66	$93.33
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.45 / $21.38	Professional	26	$9.33	$14.45	$21.38
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $46.77 / $69.18	Professional	TC	$30.20	$46.77	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $45.71 / $85.11	Professional		$32.36	$45.71	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.22 / $21.38	Professional	26	$8.51	$11.22	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.88 / $61.66	Professional	TC	$21.88	$33.88	$61.66
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $26.92	Facility		$26.92	$26.92	$26.92
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $5.13 / $6.03 / $6.03	Facility	26	$5.13	$6.03	$6.03
Well Sense Facility/Professional Facility Modifier TC Low / Median / High Price $17.78 / $20.89 / $20.89	Facility	TC	$17.78	$20.89	$20.89