Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.57 / $20.57 / $36.86	Facility	26	$20.57	$20.57	$36.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.26 / $83.23 / $153.16	Professional		$64.26	$83.23	$153.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.13 / $18.92 / $37.53	Professional	26	$15.13	$18.92	$37.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.12 / $62.67 / $122.93	Professional	TC	$49.12	$62.67	$122.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.96 / $101.96 / $101.96	Professional		$101.96	$101.96	$101.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.50 / $15.50 / $15.50	Professional	26	$15.50	$15.50	$15.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.42 / $140.10 / $198.12	Professional		$95.42	$140.10	$198.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.41 / $28.49 / $40.29	Professional	26	$19.41	$28.49	$40.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.01 / $111.60 / $157.54	Professional	TC	$76.01	$111.60	$157.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.50 / $178.80 / $302.58	Professional		$122.50	$178.80	$302.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.50 / $40.22 / $59.04	Professional	26	$24.50	$40.22	$59.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.59 / $134.62 / $243.55	Professional	TC	$98.59	$134.62	$243.55
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $109.28 / $196.23 / $359.85	Professional		$109.28	$196.23	$359.85
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $22.22 / $38.44 / $73.19	Professional	26	$22.22	$38.44	$73.19
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $87.02 / $150.53 / $286.64	Professional	TC	$87.02	$150.53	$286.64
United Facility/Professional Professional Modifier Low / Median / High Price $85.54 / $117.41 / $202.12	Professional		$85.54	$117.41	$202.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.46 / $26.73 / $51.76	Professional	26	$21.46	$26.73	$51.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.16 / $105.80 / $176.60	Professional	TC	$75.16	$105.80	$176.60
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $67.31 / $86.02 / $131.94	Professional		$67.31	$86.02	$131.94
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $15.89 / $18.69 / $26.04	Professional	26	$15.89	$18.69	$26.04
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $48.07 / $67.61 / $94.65	Professional	TC	$48.07	$67.61	$94.65