Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.42 / $60.69 / $60.69	Facility	26	$16.42	$60.69	$60.69
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.67 / $111.08 / $506.30	Facility	TC	$48.67	$111.08	$506.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $42.91 / $131.38	Professional		$35.15	$42.91	$131.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $14.49 / $42.64	Professional	26	$12.88	$14.49	$42.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.28 / $30.94 / $88.73	Professional	TC	$22.28	$30.94	$88.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $35.22 / $35.22	Professional		$35.22	$35.22	$35.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.30 / $10.81 / $12.72	Professional	26	$10.30	$10.81	$12.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $63.64 / $91.25	Professional		$43.34	$63.64	$91.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.94 / $19.00 / $27.55	Professional	26	$12.94	$19.00	$27.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.41 / $44.64 / $63.12	Professional	TC	$30.41	$44.64	$63.12
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $262.41 / $262.41 / $262.41	Facility	TC	$262.41	$262.41	$262.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.75 / $91.51 / $137.46	Professional		$57.75	$91.51	$137.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.93 / $27.14 / $40.47	Professional	26	$16.93	$27.14	$40.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.81 / $64.67 / $96.57	Professional	TC	$40.81	$64.67	$96.57
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $49.62 / $88.18 / $163.44	Professional		$49.62	$88.18	$163.44
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $14.81 / $24.36 / $45.71	Professional	26	$14.81	$24.36	$45.71
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $34.81 / $61.14 / $114.67	Professional	TC	$34.81	$61.14	$114.67
United Facility/Professional Professional Modifier Low / Median / High Price $49.23 / $60.01 / $125.32	Professional		$49.23	$60.01	$125.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.80 / $19.46 / $44.66	Professional	26	$16.80	$19.46	$44.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.53 / $41.14 / $77.81	Professional	TC	$31.53	$41.14	$77.81
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $42.19 / $62.02	Professional		$35.15	$42.19	$62.02
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $11.15 / $13.94 / $19.85	Professional	26	$11.15	$13.94	$19.85
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $24.01 / $28.57 / $38.65	Professional	TC	$24.01	$28.57	$38.65