Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.17 / $66.03 / $66.03	Facility	26	$22.17	$66.03	$66.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.22 / $67.39 / $208.86	Professional		$49.22	$67.39	$208.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.39 / $17.26 / $48.01	Professional	26	$12.39	$17.26	$48.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.83 / $51.21 / $158.12	Professional	TC	$36.83	$51.21	$158.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.25 / $63.52 / $85.51	Professional		$48.25	$63.52	$85.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.44 / $27.81 / $33.54	Professional	26	$11.44	$27.81	$33.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.52 / $87.38 / $125.29	Professional		$59.52	$87.38	$125.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.23 / $20.90 / $29.55	Professional	26	$14.23	$20.90	$29.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.29 / $66.48 / $94.03	Professional	TC	$45.29	$66.48	$94.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.40 / $127.10 / $188.00	Professional		$79.40	$127.10	$188.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.59 / $29.79 / $44.44	Professional	26	$18.59	$29.79	$44.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.82 / $96.37 / $144.91	Professional	TC	$60.82	$96.37	$144.91
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $68.14 / $117.87 / $224.46	Professional		$68.14	$117.87	$224.46
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $16.29 / $26.85 / $50.28	Professional	26	$16.29	$26.85	$50.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $51.84 / $91.93 / $170.77	Professional	TC	$51.84	$91.93	$170.77
United Facility/Professional Professional Modifier Low / Median / High Price $71.53 / $77.38 / $273.39	Professional		$71.53	$77.38	$273.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $20.39 / $44.63	Professional	26	$16.57	$20.39	$44.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.23 / $59.24 / $125.37	Professional	TC	$49.23	$59.24	$125.37
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $47.58 / $57.10 / $84.86	Professional		$47.58	$57.10	$84.86
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $11.68 / $14.48 / $21.15	Professional	26	$11.68	$14.48	$21.15
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $35.89 / $42.71 / $64.01	Professional	TC	$35.89	$42.71	$64.01