Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.10 / $150.15 / $479.81	Facility		$28.10	$150.15	$479.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $13.28	Facility	26	$9.30	$9.30	$13.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.80 / $29.90 / $349.70	Facility	TC	$18.80	$29.90	$349.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.16 / $28.10 / $53.67	Professional		$22.16	$28.10	$53.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $8.49 / $16.73	Professional	26	$7.03	$8.49	$16.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.12 / $18.80 / $40.58	Professional	TC	$15.12	$18.80	$40.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.44 / $31.01 / $70.73	Professional		$22.44	$31.01	$70.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $9.81 / $27.78	Professional	26	$6.42	$9.81	$27.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.16 / $18.16 / $18.16	Professional	TC	$18.16	$18.16	$18.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.72 / $155.49 / $172.73	Facility		$123.72	$155.49	$172.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.11 / $42.74 / $60.44	Professional		$29.11	$42.74	$60.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $12.35 / $17.46	Professional	26	$8.41	$12.35	$17.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.70 / $30.39 / $42.97	Professional	TC	$20.70	$30.39	$42.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.79 / $148.85 / $521.64	Facility		$99.79	$148.85	$521.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.54 / $58.48 / $92.74	Professional		$37.54	$58.48	$92.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.95 / $17.48 / $26.00	Professional	26	$10.95	$17.48	$26.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.02 / $40.53 / $66.47	Professional	TC	$27.02	$40.53	$66.47
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $33.33 / $59.11 / $109.79	Professional		$33.33	$59.11	$109.79
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $15.88 / $31.72	Professional	26	$9.63	$15.88	$31.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $23.70 / $42.12 / $78.06	Professional	TC	$23.70	$42.12	$78.06
United Facility/Professional Professional Modifier Low / Median / High Price $28.85 / $38.47 / $74.80	Professional		$28.85	$38.47	$74.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.47 / $12.13 / $24.69	Professional	26	$9.47	$12.13	$24.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.39 / $29.46 / $92.33	Professional	TC	$20.39	$29.46	$92.33
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $23.23 / $27.13 / $40.98	Professional		$23.23	$27.13	$40.98
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $7.02 / $8.42 / $12.17	Professional	26	$7.02	$8.42	$12.17
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