Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $31.62 / $60.26	Facility	26	$16.60	$31.62	$60.26
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.62 / $112.20 / $501.19	Facility	TC	$31.62	$112.20	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $45.71 / $109.65	Professional		$36.31	$45.71	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.85 / $50.12	Professional	26	$12.02	$15.85	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.90 / $63.10	Professional	TC	$22.91	$30.90	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.11 / $33.88	Professional		$33.11	$33.11	$33.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $16.22	Professional	26	$16.22	$16.22	$16.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $70.79 / $100.00	Professional		$43.65	$70.79	$100.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $20.89 / $30.20	Professional	26	$12.88	$20.89	$30.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $48.98 / $66.07	Professional	TC	$30.90	$48.98	$66.07
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	TC	$263.03	$263.03	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $83.18 / $134.90	Professional		$57.54	$83.18	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $29.51 / $40.74	Professional	26	$16.98	$29.51	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $54.95 / $95.50	Professional	TC	$39.81	$54.95	$95.50
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $83.18 / $123.03	Professional		$51.29	$83.18	$123.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $23.44 / $34.67	Professional	26	$15.14	$23.44	$34.67
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $58.88 / $85.11	Professional	TC	$35.48	$58.88	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $63.10 / $123.03	Professional		$47.86	$63.10	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $19.05 / $42.66	Professional	26	$15.14	$19.05	$42.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $41.69 / $77.62	Professional	TC	$31.62	$41.69	$77.62
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $10.00 / $10.00	Facility	26	$8.51	$10.00	$10.00
Well Sense Facility/Professional Facility Modifier TC Low / Median / High Price $21.38 / $25.12 / $25.12	Facility	TC	$21.38	$25.12	$25.12