Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.58 / $41.92 / $84.54	Facility	26	$22.58	$41.92	$84.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.95 / $91.76 / $253.23	Professional		$69.95	$91.76	$253.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.12 / $22.59 / $64.84	Professional	26	$17.12	$22.59	$64.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.84 / $69.18 / $193.15	Professional	TC	$52.84	$69.18	$193.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.53 / $71.53 / $71.53	Professional		$71.53	$71.53	$71.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.05 / $22.98 / $52.73	Professional	26	$21.05	$22.98	$52.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.16 / $136.77 / $193.42	Professional		$93.16	$136.77	$193.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.49 / $40.36 / $57.09	Professional	26	$27.49	$40.36	$57.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.66 / $96.40 / $136.32	Professional	TC	$65.66	$96.40	$136.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.57 / $172.23 / $297.83	Professional		$120.57	$172.23	$297.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.56 / $45.42 / $85.40	Professional	26	$31.56	$45.42	$85.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $86.57 / $127.93 / $213.85	Professional	TC	$86.57	$127.93	$213.85
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $106.65 / $189.54 / $351.32	Professional		$106.65	$189.54	$351.32
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $31.48 / $54.45 / $103.70	Professional	26	$31.48	$54.45	$103.70
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $75.17 / $130.03 / $247.62	Professional	TC	$75.17	$130.03	$247.62
United Facility/Professional Professional Modifier Low / Median / High Price $84.19 / $127.14 / $241.96	Professional		$84.19	$127.14	$241.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.76 / $39.88 / $135.99	Professional	26	$23.76	$39.88	$135.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.81 / $93.97 / $230.42	Professional	TC	$67.81	$93.97	$230.42
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $76.89 / $89.81 / $135.63	Professional		$76.89	$89.81	$135.63
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $20.73 / $26.28 / $34.54	Professional	26	$20.73	$26.28	$34.54
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $53.47 / $62.91 / $88.83	Professional	TC	$53.47	$62.91	$88.83