Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $21.88 / $56.23	Facility	26	$15.49	$21.88	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $56.23 / $181.97	Professional		$40.74	$56.23	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.89 / $44.67	Professional	26	$10.96	$20.89	$44.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $40.74 / $128.82	Professional	TC	$28.84	$40.74	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.69 / $83.18	Professional		$32.36	$41.69	$83.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $15.85 / $41.69	Professional	26	$9.55	$15.85	$41.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $81.28 / $117.49	Professional		$53.70	$81.28	$117.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $19.50 / $27.54	Professional	26	$12.59	$19.50	$27.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $61.66 / $85.11	Professional	TC	$40.74	$61.66	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $93.33 / $154.88	Professional		$67.61	$93.33	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $27.54 / $40.74	Professional	26	$16.22	$27.54	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $67.61 / $120.23	Professional	TC	$47.86	$67.61	$120.23
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $95.50 / $147.91	Professional		$61.66	$95.50	$147.91
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 $46.77 / $74.13 / $107.15	Professional	TC	$46.77	$74.13	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $67.61 / $134.90	Professional		$51.29	$67.61	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $17.38 / $38.90	Professional	26	$13.49	$17.38	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $51.29 / $95.50	Professional	TC	$37.15	$51.29	$95.50
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