Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.03 / $44.29 / $44.29	Facility	26	$12.03	$44.29	$44.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.14 / $49.18 / $135.77	Professional		$37.14	$49.18	$135.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $11.28 / $31.38	Professional	26	$9.61	$11.28	$31.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.52 / $37.14 / $104.41	Professional	TC	$27.52	$37.14	$104.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $8.85 / $8.85	Professional	26	$8.85	$8.85	$8.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.43 / $75.51 / $106.78	Professional		$51.43	$75.51	$106.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.00 / $16.14 / $22.83	Professional	26	$11.00	$16.14	$22.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.43 / $59.36 / $83.94	Professional	TC	$40.43	$59.36	$83.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.78 / $96.04 / $162.50	Professional		$65.78	$96.04	$162.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.38 / $23.05 / $34.13	Professional	26	$14.38	$23.05	$34.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.81 / $71.76 / $128.46	Professional	TC	$51.81	$71.76	$128.46
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $59.89 / $112.18 / $193.96	Professional		$59.89	$112.18	$193.96
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $20.51 / $38.86	Professional	26	$12.59	$20.51	$38.86
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $46.29 / $80.06 / $152.47	Professional	TC	$46.29	$80.06	$152.47
United Facility/Professional Professional Modifier Low / Median / High Price $47.69 / $68.03 / $128.65	Professional		$47.69	$68.03	$128.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.90 / $15.88 / $32.20	Professional	26	$11.90	$15.88	$32.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.70 / $51.61 / $98.54	Professional	TC	$39.70	$51.61	$98.54
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $41.35 / $48.30 / $72.94	Professional		$41.35	$48.30	$72.94
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $11.20 / $15.31	Professional	26	$9.44	$11.20	$15.31
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $30.84 / $37.19 / $51.26	Professional	TC	$30.84	$37.19	$51.26