Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.64 / $531.17 / $901.68	Facility		$108.64	$531.17	$901.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.66 / $41.70 / $108.97	Facility	26	$28.66	$41.70	$108.97
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $79.98 / $145.59 / $619.13	Facility	TC	$79.98	$145.59	$619.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.69 / $103.49 / $299.35	Professional		$72.69	$103.49	$299.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.66 / $74.47	Professional	26	$21.88	$28.66	$74.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.80 / $79.98 / $224.87	Professional	TC	$50.80	$79.98	$224.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.70 / $89.58 / $283.19	Professional		$64.70	$89.58	$283.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.56 / $22.06 / $63.38	Professional	26	$20.56	$22.06	$63.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $357.51 / $449.29 / $499.11	Facility		$357.51	$449.29	$499.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.10 / $123.47 / $173.11	Professional		$84.10	$123.47	$173.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.85 / $39.42 / $55.27	Professional	26	$26.85	$39.42	$55.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.25 / $84.06 / $117.86	Professional	TC	$57.25	$84.06	$117.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $282.58 / $490.72 / $638.85	Facility		$282.58	$490.72	$638.85
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $414.68 / $414.68 / $414.68	Facility	TC	$414.68	$414.68	$414.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.67 / $168.93 / $272.97	Professional		$107.67	$168.93	$272.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.18 / $52.76 / $83.29	Professional	26	$33.18	$52.76	$83.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.42 / $115.03 / $188.21	Professional	TC	$74.42	$115.03	$188.21
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $96.28 / $160.31 / $317.16	Professional		$96.28	$160.31	$317.16
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $30.73 / $50.55 / $94.85	Professional	26	$30.73	$50.55	$94.85
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $65.54 / $113.37 / $202.29	Professional	TC	$65.54	$113.37	$202.29
United Facility/Professional Professional Modifier Low / Median / High Price $95.67 / $114.80 / $208.40	Professional		$95.67	$114.80	$208.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.70 / $36.31 / $63.13	Professional	26	$28.70	$36.31	$63.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.70 / $81.23 / $160.41	Professional	TC	$66.70	$81.23	$160.41
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $72.86 / $87.43 / $128.53	Professional		$72.86	$87.43	$128.53
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $22.30 / $26.74 / $36.18	Professional	26	$22.30	$26.74	$36.18
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $50.39 / $60.09 / $90.14	Professional	TC	$50.39	$60.09	$90.14