Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $37.15 / $66.07	Facility	26	$37.15	$37.15	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $251.19	Professional		$85.11	$114.82	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $40.74 / $120.23	Professional	26	$28.84	$40.74	$120.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $141.25 / $380.19	Professional	50	$46.77	$141.25	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $70.79 / $138.04	Professional	TC	$56.23	$70.79	$138.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $38.90 / $120.23	Professional	26	$26.92	$38.90	$120.23
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	50	$158.49	$158.49	$158.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $151.36 / $208.93	Professional		$100.00	$151.36	$208.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $51.29 / $70.79	Professional	26	$33.88	$51.29	$70.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $229.09 / $316.23	Professional	50	$151.36	$229.09	$316.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $100.00 / $138.04	Professional	TC	$66.07	$100.00	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $177.83 / $295.12	Professional		$123.03	$177.83	$295.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $61.66 / $102.33	Professional	26	$41.69	$61.66	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $125.89 / $204.17	Professional	TC	$81.28	$125.89	$204.17
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $173.78 / $269.15	Professional		$114.82	$173.78	$269.15
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $60.26 / $89.13	Professional	26	$39.81	$60.26	$89.13
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $120.23 / $177.83	Professional	TC	$77.62	$120.23	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $281.84	Professional		$112.20	$144.54	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $47.86 / $91.20	Professional	26	$37.15	$47.86	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $97.72 / $190.55	Professional	TC	$75.86	$97.72	$190.55