Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.50 / $22.07 / $56.16	Facility	26	$15.50	$22.07	$56.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.84 / $53.11 / $147.66	Professional		$34.84	$53.11	$147.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $15.13 / $40.33	Professional	26	$11.69	$15.13	$40.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.15 / $38.18 / $107.33	Professional	TC	$23.15	$38.18	$107.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.10 / $55.95 / $127.61	Professional		$40.10	$55.95	$127.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.72 / $12.40 / $41.75	Professional	26	$9.72	$12.40	$41.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.93 / $34.93 / $34.93	Professional	TC	$34.93	$34.93	$34.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.40 / $76.93 / $108.79	Professional		$52.40	$76.93	$108.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.62 / $18.52 / $26.55	Professional	26	$12.62	$18.52	$26.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.79 / $58.41 / $82.45	Professional	TC	$39.79	$58.41	$82.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.56 / $104.36 / $164.45	Professional		$66.56	$104.36	$164.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.51 / $26.81 / $39.47	Professional	26	$16.51	$26.81	$39.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.17 / $73.75 / $125.78	Professional	TC	$51.17	$73.75	$125.78
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $59.99 / $106.61 / $197.61	Professional		$59.99	$106.61	$197.61
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $14.44 / $24.98 / $47.57	Professional	26	$14.44	$24.98	$47.57
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $45.55 / $80.78 / $150.05	Professional	TC	$45.55	$80.78	$150.05
United Facility/Professional Professional Modifier Low / Median / High Price $52.72 / $64.90 / $117.05	Professional		$52.72	$64.90	$117.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $17.69 / $40.15	Professional	26	$14.49	$17.69	$40.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.53 / $48.07 / $81.77	Professional	TC	$37.53	$48.07	$81.77
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $40.40 / $48.48 / $71.27	Professional		$40.40	$48.48	$71.27
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $13.25 / $17.82	Professional	26	$10.60	$13.25	$17.82
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $28.92 / $34.82 / $47.99	Professional	TC	$28.92	$34.82	$47.99