Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $28.18 / $39.81	Facility	26	$28.18	$28.18	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $114.82 / $213.80	Professional		$52.48	$114.82	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $48.98 / $128.82	Professional	26	$23.44	$48.98	$128.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	50	$138.04	$138.04	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $52.48 / $114.82	Professional	TC	$10.00	$52.48	$114.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $41.69	Professional		$41.69	$41.69	$41.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $53.70	Professional	26	$53.70	$53.70	$53.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $61.66 / $97.72	Professional		$53.70	$61.66	$97.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $45.71 / $64.57	Professional	26	$42.66	$45.71	$64.57
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $81.28 / $87.10 / $131.83	Professional	50	$81.28	$87.10	$131.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $11.75 / $19.50	Professional	TC	$10.96	$11.75	$19.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $125.89 / $269.15	Professional		$69.18	$125.89	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $61.66 / $109.65	Professional	26	$37.15	$61.66	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $33.88 / $204.17	Professional	TC	$14.45	$33.88	$204.17
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.72 / $151.36	Professional		$63.10	$97.72	$151.36
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $77.62 / $114.82	Professional	26	$48.98	$77.62	$114.82
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $19.95 / $34.67	Professional	TC	$12.88	$19.95	$34.67
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $223.87	Professional		$70.79	$109.65	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $48.98 / $97.72	Professional	26	$32.36	$48.98	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $58.88 / $147.91	Professional	TC	$14.45	$58.88	$147.91