Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $537.03 / $912.01	Facility		$114.82	$537.03	$912.01
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $41.69 / $109.65	Facility	26	$28.84	$41.69	$109.65
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $74.13 / $144.54 / $645.65	Facility	TC	$74.13	$144.54	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $309.03	Professional		$72.44	$107.15	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.90 / $89.13	Professional	26	$22.91	$38.90	$89.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $79.43 / $218.78	Professional	TC	$50.12	$79.43	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $281.84	Professional		$70.79	$100.00	$281.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $33.88 / $89.13	Professional	26	$20.89	$33.88	$89.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $42.66 / $48.98	Professional	TC	$39.81	$42.66	$48.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $478.63 / $537.03	Facility		$389.05	$478.63	$537.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $134.90 / $177.83	Professional		$87.10	$134.90	$177.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $40.74 / $57.54	Professional	26	$27.54	$40.74	$57.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $89.13 / $123.03	Professional	TC	$58.88	$89.13	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $501.19 / $645.65	Facility		$316.23	$501.19	$645.65
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $416.87 / $416.87 / $416.87	Facility	TC	$416.87	$416.87	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $158.49 / $263.03	Professional		$104.71	$158.49	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $47.86 / $77.62	Professional	26	$32.36	$47.86	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $112.20 / $181.97	Professional	TC	$70.79	$112.20	$181.97
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $229.09	Professional		$100.00	$154.88	$229.09
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $48.98 / $72.44	Professional	26	$32.36	$48.98	$72.44
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $104.71 / $154.88	Professional	TC	$69.18	$104.71	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $123.03 / $239.88	Professional		$95.50	$123.03	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $38.90 / $74.13	Professional	26	$30.20	$38.90	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $85.11 / $162.18	Professional	TC	$66.07	$85.11	$162.18