Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.40 / $29.88 / $57.46	Facility	26	$15.40	$29.88	$57.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.97 / $50.64 / $147.34	Professional		$36.97	$50.64	$147.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.08 / $14.39 / $40.00	Professional	26	$12.08	$14.39	$40.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.90 / $38.17 / $107.33	Professional	TC	$24.90	$38.17	$107.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.42 / $123.42 / $123.42	Professional		$123.42	$123.42	$123.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.96 / $17.34 / $28.52	Professional	26	$11.96	$17.34	$28.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.78 / $74.56 / $105.44	Professional		$50.78	$74.56	$105.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.88 / $21.85 / $30.90	Professional	26	$14.88	$21.85	$30.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.90 / $52.71 / $74.54	Professional	TC	$35.90	$52.71	$74.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.25 / $105.22 / $161.06	Professional		$65.25	$105.22	$161.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.18 / $31.01 / $45.97	Professional	26	$19.18	$31.01	$45.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.59 / $72.27 / $115.09	Professional	TC	$46.59	$72.27	$115.09
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $58.14 / $103.33 / $191.52	Professional		$58.14	$103.33	$191.52
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $17.03 / $26.76 / $48.24	Professional	26	$17.03	$26.76	$48.24
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $41.10 / $72.18 / $135.38	Professional	TC	$41.10	$72.18	$135.38
United Facility/Professional Professional Modifier Low / Median / High Price $52.71 / $66.59 / $128.78	Professional		$52.71	$66.59	$128.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.34 / $21.54 / $44.62	Professional	26	$15.34	$21.54	$44.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.89 / $45.98 / $82.46	Professional	TC	$36.89	$45.98	$82.46
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $48.58 / $72.08	Professional		$40.86	$48.58	$72.08
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $12.41 / $14.60 / $20.13	Professional	26	$12.41	$14.60	$20.13
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $28.15 / $33.75 / $45.65	Professional	TC	$28.15	$33.75	$45.65