Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.22 / $16.22 / $34.67	Facility	26	$16.22	$16.22	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $229.09	Professional		$52.48	$70.79	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $25.12 / $52.48	Professional	26	$12.30	$25.12	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $52.48 / $144.54	Professional	TC	$38.90	$52.48	$144.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $107.15	Professional		$74.13	$74.13	$107.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.02 / $50.12	Professional	26	$10.96	$12.02	$50.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $144.54	Professional		$72.44	$109.65	$144.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $23.44 / $33.88	Professional	26	$15.14	$23.44	$33.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $87.10 / $114.82	Professional	TC	$56.23	$87.10	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $114.82 / $213.80	Professional		$89.13	$114.82	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $30.20 / $44.67	Professional	26	$18.20	$30.20	$44.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $91.20 / $169.82	Professional	TC	$67.61	$91.20	$169.82
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $128.82 / $190.55	Professional		$83.18	$128.82	$190.55
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $26.92 / $39.81	Professional	26	$17.38	$26.92	$39.81
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $102.33 / $151.36	Professional	TC	$66.07	$102.33	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $95.50 / $177.83	Professional		$69.18	$95.50	$177.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $21.38 / $40.74	Professional	26	$16.60	$21.38	$40.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $74.13 / $134.90	Professional	TC	$51.29	$74.13	$134.90
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $11.22 / $11.22	Facility	26	$9.55	$11.22	$11.22