Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $12.59 / $12.59	Facility	26	$12.59	$12.59	$12.59
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $56.23 / $169.82 / $177.83	Facility	TC	$56.23	$169.82	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $26.92 / $57.54	Professional		$19.95	$26.92	$57.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $27.54	Professional	26	$6.03	$8.91	$27.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $19.95 / $40.74	Professional	TC	$15.14	$19.95	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $6.03 / $6.03	Professional	26	$6.03	$6.03	$6.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $46.77 / $61.66	Professional		$29.51	$46.77	$61.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.59 / $18.20	Professional	26	$7.94	$12.59	$18.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.88 / $44.67	Professional	TC	$21.38	$33.88	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $51.29 / $87.10	Professional		$38.02	$51.29	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $16.22 / $23.99	Professional	26	$9.77	$16.22	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $38.02 / $66.07	Professional	TC	$27.54	$38.02	$66.07
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $53.70 / $77.62	Professional		$33.11	$53.70	$77.62
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.80 / $19.95	Professional	26	$9.33	$13.80	$19.95
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $40.74 / $58.88	Professional	TC	$24.55	$40.74	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $40.74 / $77.62	Professional		$29.51	$40.74	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $11.22 / $21.38	Professional	26	$8.71	$11.22	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.84 / $53.70	Professional	TC	$21.38	$28.84	$53.70
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $5.13 / $6.03 / $6.03	Facility	26	$5.13	$6.03	$6.03
Well Sense Facility/Professional Facility Modifier TC Low / Median / High Price $14.45 / $16.98 / $16.98	Facility	TC	$14.45	$16.98	$16.98