Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.87 / $33.07 / $66.03	Facility	26	$17.87	$33.07	$66.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.84 / $67.65 / $188.09	Professional		$43.84	$67.65	$188.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.70 / $16.71 / $46.45	Professional	26	$13.70	$16.71	$46.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.14 / $50.36 / $141.61	Professional	TC	$30.14	$50.36	$141.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.45 / $86.45 / $86.45	Professional		$86.45	$86.45	$86.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $17.87 / $45.89	Professional	26	$10.60	$17.87	$45.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.16 / $88.33 / $124.91	Professional		$60.16	$88.33	$124.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.91 / $20.42 / $29.60	Professional	26	$13.91	$20.42	$29.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.26 / $67.91 / $95.86	Professional	TC	$46.26	$67.91	$95.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.18 / $127.20 / $191.99	Professional		$79.18	$127.20	$191.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $29.09 / $43.74	Professional	26	$18.14	$29.09	$43.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.34 / $90.69 / $149.04	Professional	TC	$61.34	$90.69	$149.04
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $68.88 / $122.41 / $226.90	Professional		$68.88	$122.41	$226.90
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $15.92 / $27.54 / $52.44	Professional	26	$15.92	$27.54	$52.44
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $52.95 / $93.00 / $174.42	Professional	TC	$52.95	$93.00	$174.42
United Facility/Professional Professional Modifier Low / Median / High Price $62.81 / $80.98 / $166.63	Professional		$62.81	$80.98	$166.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $20.39 / $45.03	Professional	26	$17.07	$20.39	$45.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.65 / $58.17 / $99.40	Professional	TC	$47.65	$58.17	$99.40
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $47.58 / $57.10 / $83.93	Professional		$47.58	$57.10	$83.93
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $11.68 / $14.60 / $21.15	Professional	26	$11.68	$14.60	$21.15
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $35.63 / $42.71 / $57.78	Professional	TC	$35.63	$42.71	$57.78