Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.32 / $16.32 / $29.25	Facility	26	$16.32	$16.32	$29.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.80 / $54.86 / $74.11	Professional		$44.80	$54.86	$74.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.00 / $14.36 / $19.55	Professional	26	$12.00	$14.36	$19.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $41.88 / $57.46	Professional	TC	$32.79	$41.88	$57.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.79 / $86.44 / $146.44	Professional		$48.79	$86.44	$146.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $18.72 / $48.06	Professional	26	$11.70	$18.72	$48.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.04 / $40.04 / $40.04	Professional	TC	$40.04	$40.04	$40.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.16 / $88.33 / $124.91	Professional		$60.16	$88.33	$124.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.56 / $21.37 / $30.22	Professional	26	$14.56	$21.37	$30.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.61 / $66.95 / $94.69	Professional	TC	$45.61	$66.95	$94.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.88 / $121.03 / $189.90	Professional		$76.88	$121.03	$189.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.01 / $30.47 / $44.98	Professional	26	$19.01	$30.47	$44.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.67 / $86.63 / $144.91	Professional	TC	$58.67	$86.63	$144.91
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $68.88 / $122.41 / $226.90	Professional		$68.88	$122.41	$226.90
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $16.66 / $28.82 / $54.88	Professional	26	$16.66	$28.82	$54.88
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $52.21 / $90.31 / $171.98	Professional	TC	$52.21	$90.31	$171.98
United Facility/Professional Professional Modifier Low / Median / High Price $60.03 / $76.89 / $146.72	Professional		$60.03	$76.89	$146.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.72 / $21.10 / $43.45	Professional	26	$16.72	$21.10	$43.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.74 / $56.77 / $111.51	Professional	TC	$44.74	$56.77	$111.51
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $38.86 / $54.35 / $83.37	Professional		$38.86	$54.35	$83.37
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $11.90 / $14.30 / $20.63	Professional	26	$11.90	$14.30	$20.63
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $26.98 / $40.27 / $56.38	Professional	TC	$26.98	$40.27	$56.38