Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $407.38 / $691.83	Facility		$91.20	$407.38	$691.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $74.13	Facility	26	$34.67	$34.67	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $93.33 / $269.15	Professional		$60.26	$93.33	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $61.66 / $107.15	Professional	26	$26.92	$61.66	$107.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $144.54 / $630.96	Professional	50	$47.86	$144.54	$630.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $58.88 / $144.54	Professional	TC	$43.65	$58.88	$144.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $89.13 / $275.42	Professional		$67.61	$89.13	$275.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $45.71 / $104.71	Professional	26	$25.12	$45.71	$104.71
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $100.00 / $131.83 / $302.00	Professional	50	$100.00	$131.83	$302.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $467.74 / $524.81	Facility		$371.54	$467.74	$524.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $125.89 / $173.78	Professional		$83.18	$125.89	$173.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $46.77 / $66.07	Professional	26	$31.62	$46.77	$66.07
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $125.89 / $190.55 / $263.03	Professional	50	$125.89	$190.55	$263.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $77.62 / $107.15	Professional	TC	$52.48	$77.62	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $416.87 / $524.81	Facility		$257.04	$416.87	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $144.54 / $245.47	Professional		$102.33	$144.54	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $57.54 / $95.50	Professional	26	$38.90	$57.54	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $97.72 / $158.49	Professional	TC	$63.10	$97.72	$158.49
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $223.87	Professional		$91.20	$141.25	$223.87
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $52.48 / $83.18	Professional	26	$37.15	$52.48	$83.18
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $93.33 / $138.04	Professional	TC	$61.66	$93.33	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $229.09	Professional		$93.33	$120.23	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $44.67 / $85.11	Professional	26	$34.67	$44.67	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $74.13 / $144.54	Professional	TC	$57.54	$74.13	$144.54