Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $13.49 / $28.84	Facility	26	$13.49	$13.49	$28.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $43.65 / $109.65	Professional		$32.36	$43.65	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $19.05 / $38.02	Professional	26	$10.00	$19.05	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.84 / $79.43	Professional	TC	$20.89	$28.84	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Professional		$42.66	$42.66	$42.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $41.69 / $41.69	Professional	26	$41.69	$41.69	$41.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $67.61 / $89.13	Professional		$43.65	$67.61	$89.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $19.05 / $27.54	Professional	26	$12.59	$19.05	$27.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $47.86 / $63.10	Professional	TC	$31.62	$47.86	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $72.44 / $128.82	Professional		$54.95	$72.44	$128.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $24.55 / $36.31	Professional	26	$14.79	$24.55	$36.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $50.12 / $93.33	Professional	TC	$37.15	$50.12	$93.33
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $85.11 / $125.89	Professional		$51.29	$85.11	$125.89
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $22.91 / $33.88	Professional	26	$14.79	$22.91	$33.88
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $57.54 / $85.11	Professional	TC	$36.31	$57.54	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $112.20	Professional		$42.66	$58.88	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $17.78 / $33.88	Professional	26	$13.80	$17.78	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $40.74 / $75.86	Professional	TC	$28.18	$40.74	$75.86
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $9.33 / $9.33	Facility	26	$7.76	$9.33	$9.33