Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.53 / $20.13 / $26.09	Facility	26	$14.53	$20.13	$26.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $50.07 / $63.55	Professional		$40.86	$50.07	$63.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.69 / $12.78 / $16.97	Professional	26	$10.69	$12.78	$16.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.18 / $36.67 / $46.58	Professional	TC	$30.18	$36.67	$46.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.42 / $10.80 / $30.48	Professional	26	$10.42	$10.80	$30.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.87 / $86.43 / $122.22	Professional		$58.87	$86.43	$122.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.94 / $19.00 / $26.86	Professional	26	$12.94	$19.00	$26.86
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $88.30 / $129.63 / $183.34	Professional	50	$88.30	$129.63	$183.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.93 / $67.44 / $95.20	Professional	TC	$45.93	$67.44	$95.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.48 / $110.37 / $183.99	Professional		$74.48	$110.37	$183.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $26.46 / $39.07	Professional	26	$16.89	$26.46	$39.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.67 / $82.79 / $144.51	Professional	TC	$58.67	$82.79	$144.51
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $68.41 / $128.38 / $221.99	Professional		$68.41	$128.38	$221.99
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $14.81 / $25.62 / $48.79	Professional	26	$14.81	$25.62	$48.79
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $52.58 / $93.45 / $173.20	Professional	TC	$52.58	$93.45	$173.20
United Facility/Professional Professional Modifier Low / Median / High Price $56.81 / $70.31 / $133.93	Professional		$56.81	$70.31	$133.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.24 / $17.69 / $36.63	Professional	26	$14.24	$17.69	$36.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.00 / $55.37 / $100.18	Professional	TC	$43.00	$55.37	$100.18
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $37.09 / $51.46 / $78.94	Professional		$37.09	$51.46	$78.94
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $12.38 / $18.36	Professional	26	$10.11	$12.38	$18.36
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $26.98 / $39.28 / $55.00	Professional	TC	$26.98	$39.28	$55.00