Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.86 / $355.87 / $827.10	Facility		$115.86	$355.87	$827.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.30 / $39.01 / $100.37	Facility	26	$27.30	$39.01	$100.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.02 / $120.53 / $330.12	Professional		$93.02	$120.53	$330.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.68 / $27.30 / $70.97	Professional	26	$20.68	$27.30	$70.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.51 / $60.27 / $65.92	Professional	52	$46.51	$60.27	$65.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.34 / $93.21 / $253.39	Professional	TC	$72.34	$93.21	$253.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.34 / $113.22 / $357.91	Professional		$81.34	$113.22	$357.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.78 / $25.44 / $61.05	Professional	26	$19.78	$25.44	$61.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $452.11 / $568.17 / $631.17	Facility		$452.11	$568.17	$631.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.10 / $155.77 / $218.40	Professional		$106.10	$155.77	$218.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.88 / $37.99 / $53.26	Professional	26	$25.88	$37.99	$53.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.22 / $117.78 / $165.13	Professional	TC	$80.22	$117.78	$165.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $396.62 / $638.85 / $712.94	Facility		$396.62	$638.85	$712.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $204.24 / $345.92	Professional		$130.08	$204.24	$345.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.25 / $49.77 / $80.33	Professional	26	$32.25	$49.77	$80.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.35 / $155.97 / $264.18	Professional	TC	$87.35	$155.97	$264.18
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $121.46 / $213.32 / $400.10	Professional		$121.46	$213.32	$400.10
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $29.62 / $49.63 / $97.57	Professional	26	$29.62	$49.63	$97.57
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $91.83 / $158.85 / $283.43	Professional	TC	$91.83	$158.85	$283.43
United Facility/Professional Professional Modifier Low / Median / High Price $103.27 / $146.44 / $266.14	Professional		$103.27	$146.44	$266.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.41 / $36.22 / $74.70	Professional	26	$26.41	$36.22	$74.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.29 / $111.44 / $203.67	Professional	TC	$79.29	$111.44	$203.67
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $93.22 / $108.88 / $164.44	Professional		$93.22	$108.88	$164.44
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $21.52 / $25.38 / $34.90	Professional	26	$21.52	$25.38	$34.90
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $17.69 / $17.69 / $23.88	Professional	52	$17.69	$17.69	$23.88
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $71.03 / $83.56 / $120.95	Professional	TC	$71.03	$83.56	$120.95