Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.67 / $40.67 / $109.05	Facility	26	$28.67	$40.67	$109.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.63 / $111.85 / $313.19	Professional		$44.63	$111.85	$313.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.18 / $28.67 / $74.61	Professional	26	$21.18	$28.67	$74.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $75.81 / $238.60	Professional	TC	$23.44	$75.81	$238.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.72 / $48.05 / $62.46	Professional		$45.72	$48.05	$62.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $21.32 / $62.61	Professional	26	$20.07	$21.32	$62.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.87 / $86.43 / $121.18	Professional		$58.87	$86.43	$121.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.52 / $38.94 / $54.59	Professional	26	$26.52	$38.94	$54.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.35 / $47.49 / $66.58	Professional	TC	$32.35	$47.49	$66.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.08 / $121.63 / $227.95	Professional		$78.08	$121.63	$227.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.78 / $49.92 / $82.30	Professional	26	$32.78	$49.92	$82.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.42 / $67.73 / $121.11	Professional	TC	$43.42	$67.73	$121.11
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $67.39 / $112.93 / $221.99	Professional		$67.39	$112.93	$221.99
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $30.36 / $53.84 / $100.01	Professional	26	$30.36	$53.84	$100.01
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $37.03 / $64.05 / $121.98	Professional	TC	$37.03	$64.05	$121.98
United Facility/Professional Professional Modifier Low / Median / High Price $73.75 / $103.92 / $249.42	Professional		$73.75	$103.92	$249.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.89 / $36.63 / $64.03	Professional	26	$29.89	$36.63	$64.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.88 / $41.42 / $79.90	Professional	TC	$37.88	$41.42	$79.90
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $46.51 / $62.79 / $104.94	Professional		$46.51	$62.79	$104.94
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $22.17 / $26.60 / $35.76	Professional	26	$22.17	$26.60	$35.76
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $24.30 / $29.16 / $78.34	Professional	TC	$24.30	$29.16	$78.34