Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.78 / $25.78 / $25.78	Facility	26	$25.78	$25.78	$25.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.69 / $61.64 / $89.33	Professional		$53.69	$61.64	$89.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.02 / $15.61 / $22.68	Professional	26	$13.02	$15.61	$22.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.67 / $46.00 / $66.65	Professional	TC	$40.67	$46.00	$66.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.94 / $82.94 / $82.94	Professional		$82.94	$82.94	$82.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $13.09 / $13.09	Professional	26	$13.09	$13.09	$13.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.63 / $113.98 / $161.19	Professional		$77.63	$113.98	$161.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.50 / $24.22 / $34.25	Professional	26	$16.50	$24.22	$34.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.13 / $89.76 / $126.71	Professional	TC	$61.13	$89.76	$126.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.53 / $144.74 / $243.40	Professional		$98.53	$144.74	$243.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.19 / $34.26 / $51.15	Professional	26	$21.19	$34.26	$51.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.83 / $111.50 / $192.25	Professional	TC	$77.83	$111.50	$192.25
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $88.87 / $157.94 / $292.75	Professional		$88.87	$157.94	$292.75
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $18.89 / $32.68 / $62.23	Professional	26	$18.89	$32.68	$62.23
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $72.94 / $133.34 / $230.55	Professional	TC	$72.94	$133.34	$230.55
United Facility/Professional Professional Modifier Low / Median / High Price $72.01 / $102.48 / $175.30	Professional		$72.01	$102.48	$175.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.41 / $24.40 / $44.67	Professional	26	$18.41	$24.40	$44.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.55 / $79.29 / $130.69	Professional	TC	$62.55	$79.29	$130.69
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $54.36 / $72.52 / $111.24	Professional		$54.36	$72.52	$111.24
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $14.02 / $16.48 / $22.73	Professional	26	$14.02	$16.48	$22.73
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $40.06 / $56.28 / $78.79	Professional	TC	$40.06	$56.28	$78.79