Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.57 / $31.04 / $31.04	Facility	26	$12.57	$31.04	$31.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.39 / $70.68 / $221.03	Professional		$37.39	$70.68	$221.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.38 / $7.78 / $22.61	Professional	26	$6.38	$7.78	$22.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.27 / $63.35 / $199.40	Professional	TC	$30.27	$63.35	$199.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.82 / $14.28 / $27.84	Professional	26	$11.82	$14.28	$27.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.73 / $61.26 / $87.84	Professional		$41.73	$61.26	$87.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.56 / $21.37 / $30.16	Professional	26	$14.56	$21.37	$30.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.17 / $39.89 / $57.84	Professional	TC	$27.17	$39.89	$57.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.60 / $93.50 / $177.89	Professional		$55.60	$93.50	$177.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.16 / $20.83 / $43.85	Professional	26	$12.16	$20.83	$43.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.50 / $63.70 / $117.95	Professional	TC	$36.50	$63.70	$117.95
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $47.77 / $78.75 / $157.36	Professional		$47.77	$78.75	$157.36
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $16.66 / $27.14 / $51.42	Professional	26	$16.66	$27.14	$51.42
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $31.11 / $55.17 / $102.48	Professional	TC	$31.11	$55.17	$102.48
United Facility/Professional Professional Modifier Low / Median / High Price $52.61 / $63.57 / $131.10	Professional		$52.61	$63.57	$131.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.99 / $20.44 / $70.34	Professional	26	$7.99	$20.44	$70.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.36 / $40.32 / $101.01	Professional	TC	$33.36	$40.32	$101.01
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $33.28 / $45.79 / $97.44	Professional		$33.28	$45.79	$97.44
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $11.88 / $17.82	Professional	26	$7.73	$11.88	$17.82
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $21.40 / $26.54 / $89.71	Professional	TC	$21.40	$26.54	$89.71