Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.65 / $286.16 / $674.18	Facility		$91.65	$286.16	$674.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.61 / $34.61 / $49.46	Facility	26	$34.61	$34.61	$49.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.05 / $91.65 / $160.50	Professional		$70.05	$91.65	$160.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.36 / $34.61 / $76.53	Professional	26	$25.36	$34.61	$76.53
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $109.20 / $115.80 / $218.40	Professional	50	$109.20	$115.80	$218.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.69 / $57.03 / $104.93	Professional	TC	$44.69	$57.03	$104.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.52 / $67.19 / $199.22	Professional		$63.52	$67.19	$199.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.96 / $34.67 / $103.62	Professional	26	$23.96	$34.67	$103.62
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $95.28 / $100.78 / $298.83	Professional	50	$95.28	$100.78	$298.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $124.46 / $124.46 / $124.46	Professional	TC	$124.46	$124.46	$124.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $348.30 / $437.72 / $486.26	Facility		$348.30	$437.72	$486.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.16 / $120.62 / $169.12	Professional		$82.16	$120.62	$169.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.38 / $46.07 / $64.59	Professional	26	$31.38	$46.07	$64.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $123.24 / $180.93 / $253.68	Professional	50	$123.24	$180.93	$253.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.78 / $74.56 / $104.54	Professional	TC	$50.78	$74.56	$104.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $248.21 / $417.11 / $519.30	Facility		$248.21	$417.11	$519.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $155.44 / $263.27	Professional		$105.00	$155.44	$263.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.06 / $59.37 / $97.36	Professional	26	$39.06	$59.37	$97.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.16 / $100.45 / $165.32	Professional	TC	$66.16	$100.45	$165.32
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $92.43 / $153.22 / $290.32	Professional		$92.43	$153.22	$290.32
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $35.92 / $59.81 / $118.32	Professional	26	$35.92	$59.81	$118.32
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $58.14 / $100.57 / $179.45	Professional	TC	$58.14	$100.57	$179.45
United Facility/Professional Professional Modifier Low / Median / High Price $94.07 / $113.98 / $225.45	Professional		$94.07	$113.98	$225.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.42 / $43.48 / $85.08	Professional	26	$35.42	$43.48	$85.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.59 / $73.95 / $151.81	Professional	TC	$60.59	$73.95	$151.81
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $81.45 / $123.02	Professional		$69.73	$81.45	$123.02
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $25.83 / $30.39 / $43.44	Professional	26	$25.83	$30.39	$43.44
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $43.40 / $51.06 / $74.23	Professional	TC	$43.40	$51.06	$74.23