Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.62 / $36.83 / $100.41	Facility	26	$26.62	$36.83	$100.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.92 / $88.15 / $245.08	Professional		$69.92	$88.15	$245.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.28 / $26.39 / $69.16	Professional	26	$20.28	$26.39	$69.16
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $34.96 / $37.79 / $44.86	Professional	52	$34.96	$37.79	$44.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.64 / $59.14 / $175.91	Professional	TC	$49.64	$59.14	$175.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.79 / $45.90 / $79.18	Professional		$43.79	$45.90	$79.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.10 / $21.93 / $50.31	Professional	26	$20.10	$21.93	$50.31
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $136.08 / $136.08 / $136.08	Professional	52	$136.08	$136.08	$136.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.28 / $82.63 / $116.64	Professional		$56.28	$82.63	$116.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.20 / $38.47 / $53.93	Professional	26	$26.20	$38.47	$53.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.08 / $44.17 / $61.93	Professional	TC	$30.08	$44.17	$61.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.58 / $118.53 / $195.79	Professional		$74.58	$118.53	$195.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.35 / $49.12 / $81.02	Professional	26	$32.35	$49.12	$81.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.55 / $66.79 / $127.79	Professional	TC	$41.55	$66.79	$127.79
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $44.40 / $101.75 / $212.24	Professional		$44.40	$101.75	$212.24
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $29.99 / $52.67 / $98.79	Professional	26	$29.99	$52.67	$98.79
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $34.44 / $57.71 / $113.45	Professional	TC	$34.44	$57.71	$113.45
United Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $105.99 / $226.12	Professional		$80.48	$105.99	$226.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.21 / $37.11 / $66.43	Professional	26	$28.21	$37.11	$66.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.96 / $65.55 / $158.60	Professional	TC	$54.96	$65.55	$158.60
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $78.12 / $111.13	Professional		$63.00	$78.12	$111.13
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $22.02 / $25.91 / $34.47	Professional	26	$22.02	$25.91	$34.47
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $16.64 / $16.64 / $22.48	Professional	52	$16.64	$16.64	$22.48
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $40.82 / $48.58 / $72.01	Professional	TC	$40.82	$48.58	$72.01