Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.32 / $16.32 / $29.25	Facility	26	$16.32	$16.32	$29.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.46 / $60.53 / $114.51	Professional		$49.46	$60.53	$114.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.00 / $14.36 / $20.11	Professional	26	$12.00	$14.36	$20.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.46 / $47.82 / $93.10	Professional	TC	$37.46	$47.82	$93.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.22 / $52.22 / $52.22	Professional		$52.22	$52.22	$52.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $18.72 / $48.06	Professional	26	$11.70	$18.72	$48.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.25 / $100.20 / $141.69	Professional		$68.25	$100.20	$141.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.56 / $21.37 / $30.22	Professional	26	$14.56	$21.37	$30.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $78.83 / $111.48	Professional	TC	$53.70	$78.83	$111.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.29 / $133.31 / $215.62	Professional		$87.29	$133.31	$215.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.01 / $30.47 / $44.98	Professional	26	$19.01	$30.47	$44.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.08 / $101.21 / $170.64	Professional	TC	$69.08	$101.21	$170.64
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $78.13 / $138.85 / $257.37	Professional		$78.13	$138.85	$257.37
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $16.66 / $28.82 / $54.88	Professional	26	$16.66	$28.82	$54.88
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $61.47 / $106.33 / $202.49	Professional	TC	$61.47	$106.33	$202.49
United Facility/Professional Professional Modifier Low / Median / High Price $68.77 / $88.08 / $170.79	Professional		$68.77	$88.08	$170.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.72 / $21.79 / $41.07	Professional	26	$16.72	$21.79	$41.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.49 / $67.23 / $120.49	Professional	TC	$52.49	$67.23	$120.49
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $50.08 / $62.60 / $95.56	Professional		$50.08	$62.60	$95.56
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $12.39 / $14.58 / $20.63	Professional	26	$12.39	$14.58	$20.63
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $36.90 / $47.94 / $67.12	Professional	TC	$36.90	$47.94	$67.12