Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $47.86 / $47.86	Facility	26	$47.86	$47.86	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $42.66 / $107.15	Professional		$33.11	$42.66	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.85 / $45.71	Professional	26	$10.96	$15.85	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $66.07	Professional	TC	$19.95	$28.84	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.18 / $33.11	Professional		$28.18	$28.18	$33.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $69.18 / $91.20	Professional		$42.66	$69.18	$91.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $21.38 / $30.90	Professional	26	$13.49	$21.38	$30.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $46.77 / $61.66	Professional	TC	$29.51	$46.77	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $131.83	Professional		$52.48	$72.44	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $26.92 / $40.74	Professional	26	$16.60	$26.92	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $47.86 / $91.20	Professional	TC	$36.31	$47.86	$91.20
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $77.62 / $114.82	Professional		$46.77	$77.62	$114.82
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $22.39 / $35.48	Professional	26	$15.49	$22.39	$35.48
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $53.70 / $79.43	Professional	TC	$34.67	$53.70	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $107.15	Professional		$44.67	$58.88	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.50 / $37.15	Professional	26	$13.18	$19.50	$37.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $38.90 / $70.79	Professional	TC	$28.84	$38.90	$70.79
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $10.23 / $10.23	Facility	26	$8.71	$10.23	$10.23