Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $20.89 / $26.30	Facility	26	$14.45	$20.89	$26.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $58.88 / $158.49	Professional		$39.81	$58.88	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.80 / $38.90	Professional	26	$10.96	$13.80	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $42.66 / $125.89	Professional	TC	$30.90	$42.66	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $13.49 / $13.49	Professional	26	$13.49	$13.49	$13.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $38.02 / $38.02	Professional	TC	$38.02	$38.02	$38.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $95.50 / $125.89	Professional		$63.10	$95.50	$125.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $20.89 / $29.51	Professional	26	$13.49	$20.89	$29.51
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $93.33 / $141.25 / $186.21	Professional	50	$93.33	$141.25	$186.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $74.13 / $97.72	Professional	TC	$48.98	$74.13	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $97.72 / $177.83	Professional		$74.13	$97.72	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $26.30 / $38.90	Professional	26	$16.22	$26.30	$38.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $75.86 / $144.54	Professional	TC	$57.54	$75.86	$144.54
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $112.20 / $173.78	Professional		$72.44	$112.20	$173.78
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $23.99 / $35.48	Professional	26	$15.49	$23.99	$35.48
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $89.13 / $131.83	Professional	TC	$57.54	$89.13	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $79.43 / $158.49	Professional		$56.23	$79.43	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $18.62 / $35.48	Professional	26	$14.13	$18.62	$35.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $60.26 / $117.49	Professional	TC	$41.69	$60.26	$117.49
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $9.77 / $9.77	Facility	26	$8.32	$9.77	$9.77