Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.57 / $59.42 / $59.42	Facility	26	$22.57	$59.42	$59.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.83 / $55.15 / $170.85	Professional		$28.83	$55.15	$170.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.79 / $13.58 / $40.00	Professional	26	$11.79	$13.58	$40.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.04 / $41.56 / $130.85	Professional	TC	$17.04	$41.56	$130.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $12.17 / $12.17	Professional	26	$11.72	$12.17	$12.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $58.89 / $84.44	Professional		$40.11	$58.89	$84.44
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 $25.55 / $37.52 / $53.06	Professional	TC	$25.55	$37.52	$53.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.11 / $85.46 / $154.54	Professional		$52.11	$85.46	$154.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.89 / $30.31 / $44.94	Professional	26	$18.89	$30.31	$44.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.85 / $55.02 / $110.92	Professional	TC	$33.85	$55.02	$110.92
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $43.62 / $79.43 / $151.27	Professional		$43.62	$79.43	$151.27
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $16.66 / $27.46 / $54.88	Professional	26	$16.66	$27.46	$54.88
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $29.25 / $51.37 / $90.28	Professional	TC	$29.25	$51.37	$90.28
United Facility/Professional Professional Modifier Low / Median / High Price $49.07 / $57.09 / $103.72	Professional		$49.07	$57.09	$103.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.62 / $20.39 / $41.05	Professional	26	$15.62	$20.39	$41.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.66 / $34.35 / $63.32	Professional	TC	$30.66	$34.35	$63.32
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $31.88 / $43.87 / $74.98	Professional		$31.88	$43.87	$74.98
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $14.60 / $18.55	Professional	26	$12.17	$14.60	$18.55
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $19.52 / $24.38 / $60.37	Professional	TC	$19.52	$24.38	$60.37