Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.21 / $22.21 / $22.21	Facility	26	$22.21	$22.21	$22.21
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.14 / $76.44 / $248.48	Facility	TC	$48.14	$76.44	$248.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $40.96 / $51.58	Professional		$33.86	$40.96	$51.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.50 / $14.44 / $19.94	Professional	26	$12.50	$14.44	$19.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.36 / $25.78 / $31.64	Professional	TC	$21.36	$25.78	$31.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.06 / $36.06 / $36.06	Professional		$36.06	$36.06	$36.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $11.32 / $11.32	Professional	26	$11.32	$11.32	$11.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.31 / $65.06 / $92.00	Professional		$44.31	$65.06	$92.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.23 / $20.90 / $29.55	Professional	26	$14.23	$20.90	$29.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.08 / $44.17 / $62.46	Professional	TC	$30.08	$44.17	$62.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.52 / $89.67 / $139.63	Professional		$56.52	$89.67	$139.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.63 / $29.86 / $43.64	Professional	26	$18.63	$29.86	$43.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.09 / $57.65 / $96.57	Professional	TC	$39.09	$57.65	$96.57
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $48.19 / $82.64 / $167.11	Professional		$48.19	$82.64	$167.11
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $16.29 / $25.73 / $53.66	Professional	26	$16.29	$25.73	$53.66
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $34.44 / $59.57 / $113.45	Professional	TC	$34.44	$59.57	$113.45
United Facility/Professional Professional Modifier Low / Median / High Price $45.45 / $58.21 / $107.87	Professional		$45.45	$58.21	$107.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.92 / $21.61 / $43.79	Professional	26	$16.92	$21.61	$43.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.15 / $37.33 / $70.98	Professional	TC	$29.15	$37.33	$70.98
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $41.66 / $62.92	Professional		$35.67	$41.66	$62.92
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $12.45 / $14.94 / $21.59	Professional	26	$12.45	$14.94	$21.59
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $22.98 / $26.61 / $37.26	Professional	TC	$22.98	$26.61	$37.26