Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.40 / $476.69 / $979.20	Facility		$134.40	$476.69	$979.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.96 / $48.32 / $135.44	Facility	26	$35.96	$48.32	$135.44
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $98.43 / $180.05 / $704.28	Facility	TC	$98.43	$180.05	$704.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.60 / $133.18 / $370.24	Professional		$89.60	$133.18	$370.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.16 / $35.96 / $93.43	Professional	26	$27.16	$35.96	$93.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $44.80 / $64.30 / $67.20	Professional	52	$44.80	$64.30	$67.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.45 / $98.43 / $276.80	Professional	TC	$62.45	$98.43	$276.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.54 / $85.56 / $253.69	Professional		$80.54	$85.56	$253.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.74 / $35.63 / $64.53	Professional	26	$25.74	$35.63	$64.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $443.77 / $557.69 / $619.54	Facility		$443.77	$557.69	$619.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.48 / $153.38 / $215.06	Professional		$104.48	$153.38	$215.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.64 / $49.39 / $69.23	Professional	26	$33.64	$49.39	$69.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.84 / $104.00 / $145.81	Professional	TC	$70.84	$104.00	$145.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $348.19 / $585.37 / $640.01	Facility		$348.19	$585.37	$640.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $575.04 / $575.04 / $575.04	Facility	TC	$575.04	$575.04	$575.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.24 / $209.61 / $336.94	Professional		$135.24	$209.61	$336.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.08 / $65.37 / $103.95	Professional	26	$42.08	$65.37	$103.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.99 / $142.99 / $231.92	Professional	TC	$91.99	$142.99	$231.92
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $119.61 / $206.90 / $394.01	Professional		$119.61	$206.90	$394.01
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $38.51 / $67.64 / $118.86	Professional	26	$38.51	$67.64	$118.86
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $81.09 / $140.29 / $250.32	Professional	TC	$81.09	$140.29	$250.32
United Facility/Professional Professional Modifier Low / Median / High Price $128.26 / $154.38 / $237.52	Professional		$128.26	$154.38	$237.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.53 / $47.11 / $85.30	Professional	26	$37.53	$47.11	$85.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.16 / $105.08 / $197.83	Professional	TC	$85.16	$105.08	$197.83
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $90.46 / $108.55 / $159.57	Professional		$90.46	$108.55	$159.57
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $27.99 / $33.54 / $45.38	Professional	26	$27.99	$33.54	$45.38
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $24.29 / $24.29 / $32.79	Professional	52	$24.29	$24.29	$32.79
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $62.27 / $74.72 / $113.06	Professional	TC	$62.27	$74.72	$113.06