Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $225.56 / $1,029.35 / $5,241.29	Facility		$225.56	$1,029.35	$5,241.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.42 / $211.99 / $211.99	Facility	26	$55.42	$211.99	$211.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.46 / $235.93 / $655.91	Professional		$126.46	$235.93	$655.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.70 / $55.42 / $163.24	Professional	26	$39.70	$55.42	$163.24
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $63.23 / $70.36 / $118.73	Professional	52	$63.23	$70.36	$118.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.52 / $162.66 / $511.88	Professional	TC	$84.52	$162.66	$511.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.99 / $113.99 / $113.99	Professional		$113.99	$113.99	$113.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.82 / $62.44 / $65.45	Professional	26	$58.82	$62.44	$65.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $600.94 / $755.22 / $838.97	Facility		$600.94	$755.22	$838.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.62 / $210.86 / $302.35	Professional		$143.62	$210.86	$302.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.28 / $114.93 / $162.24	Professional	26	$78.28	$114.93	$162.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.34 / $95.93 / $139.09	Professional	TC	$65.34	$95.93	$139.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $323.00 / $684.01 / $17,886.09	Facility		$323.00	$684.01	$17,886.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.18 / $320.13 / $605.07	Professional		$189.18	$320.13	$605.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.37 / $124.96 / $240.96	Professional	26	$91.37	$124.96	$240.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.72 / $158.88 / $446.76	Professional	TC	$87.72	$158.88	$446.76
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $164.41 / $291.56 / $541.58	Professional		$164.41	$291.56	$541.58
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $89.61 / $155.01 / $295.18	Professional	26	$89.61	$155.01	$295.18
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $74.80 / $124.54 / $246.40	Professional	TC	$74.80	$124.54	$246.40
United Facility/Professional Professional Modifier Low / Median / High Price $205.18 / $247.92 / $651.19	Professional		$205.18	$247.92	$651.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.53 / $110.57 / $160.00	Professional	26	$57.53	$110.57	$160.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.96 / $112.33 / $410.24	Professional	TC	$81.96	$112.33	$410.24
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $128.86 / $177.31 / $244.06	Professional		$128.86	$177.31	$244.06
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $51.84 / $70.68 / $98.58	Professional	26	$51.84	$70.68	$98.58
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $119.79 / $143.75 / $161.72	Professional	52	$119.79	$143.75	$161.72
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $63.14 / $78.29 / $188.35	Professional	TC	$63.14	$78.29	$188.35