Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.17 / $19.17 / $19.17	Facility	26	$19.17	$19.17	$19.17
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $46.59 / $73.98 / $240.48	Facility	TC	$46.59	$73.98	$240.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.60 / $35.22 / $47.82	Professional		$31.60	$35.22	$47.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.53 / $12.06 / $16.57	Professional	26	$10.53	$12.06	$16.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.06 / $23.17 / $31.24	Professional	TC	$21.06	$23.17	$31.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.64 / $100.64 / $100.64	Professional		$100.64	$100.64	$100.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $10.02 / $15.83	Professional	26	$9.44	$10.02	$15.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $60.79 / $85.96	Professional		$41.40	$60.79	$85.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $18.05 / $25.52	Professional	26	$12.29	$18.05	$25.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.11 / $42.74 / $60.44	Professional	TC	$29.11	$42.74	$60.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.25 / $83.51 / $131.53	Professional		$53.25	$83.51	$131.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.07 / $25.77 / $38.04	Professional	26	$16.07	$25.77	$38.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.84 / $56.48 / $93.48	Professional	TC	$37.84	$56.48	$93.48
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $47.40 / $81.99 / $156.13	Professional		$47.40	$81.99	$156.13
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $14.07 / $23.15 / $43.43	Professional	26	$14.07	$23.15	$43.43
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $33.33 / $57.65 / $109.79	Professional	TC	$33.33	$57.65	$109.79
United Facility/Professional Professional Modifier Low / Median / High Price $42.23 / $54.89 / $106.93	Professional		$42.23	$54.89	$106.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $17.75 / $50.06	Professional	26	$13.86	$17.75	$50.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.79 / $38.60 / $65.76	Professional	TC	$28.79	$38.60	$65.76
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $33.15 / $38.72 / $58.49	Professional		$33.15	$38.72	$58.49
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $10.31 / $12.37 / $18.19	Professional	26	$10.31	$12.37	$18.19
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $22.69 / $26.69 / $36.79	Professional	TC	$22.69	$26.69	$36.79