Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.11 / $12.11 / $12.11	Facility	26	$12.11	$12.11	$12.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.64 / $53.40 / $173.60	Facility	TC	$33.64	$53.40	$173.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $25.17 / $33.46	Professional		$21.88	$25.17	$33.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.27 / $7.50 / $8.91	Professional	26	$6.27	$7.50	$8.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.60 / $17.67 / $22.98	Professional	TC	$15.60	$17.67	$22.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.22 / $6.25 / $14.85	Professional	26	$6.22	$6.25	$14.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.79 / $42.27 / $59.77	Professional		$28.79	$42.27	$59.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.40 / $16.12	Professional	26	$7.76	$11.40	$16.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.03 / $30.87 / $43.65	Professional	TC	$21.03	$30.87	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.32 / $59.30 / $89.72	Professional		$36.32	$59.30	$89.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $16.14 / $24.01	Professional	26	$10.11	$16.14	$24.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.60 / $41.34 / $65.70	Professional	TC	$26.60	$41.34	$65.70
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $27.44 / $51.79 / $108.57	Professional		$27.44	$51.79	$108.57
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $13.97 / $25.18	Professional	26	$8.89	$13.97	$25.18
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $24.07 / $42.78 / $79.29	Professional	TC	$24.07	$42.78	$79.29
United Facility/Professional Professional Modifier Low / Median / High Price $29.62 / $38.47 / $117.27	Professional		$29.62	$38.47	$117.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $10.88 / $21.45	Professional	26	$8.73	$10.88	$21.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.37 / $27.21 / $54.15	Professional	TC	$21.37	$27.21	$54.15
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $23.28 / $27.23 / $41.07	Professional		$23.28	$27.23	$41.07
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $7.82 / $10.79	Professional	26	$6.52	$7.82	$10.79
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $16.64 / $19.96 / $27.00	Professional	TC	$16.64	$19.96	$27.00