Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.17 / $28.17 / $64.56	Facility	26	$28.17	$28.17	$64.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.23 / $103.70 / $149.87	Professional		$88.23	$103.70	$149.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.49 / $28.17 / $73.08	Professional	26	$23.49	$28.17	$73.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.50 / $78.92 / $90.75	Professional	TC	$52.50	$78.92	$90.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $41.00 / $42.92	Professional		$41.00	$41.00	$42.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.75 / $61.41 / $98.00	Professional		$51.75	$61.41	$98.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $44.35 / $69.18	Professional	26	$36.15	$44.35	$69.18
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $92.11 / $147.01	Professional	50	$77.62	$92.11	$147.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.35 / $11.80 / $35.29	Professional	TC	$10.35	$11.80	$35.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.13 / $123.22 / $252.81	Professional		$69.13	$123.22	$252.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.40 / $62.13 / $128.10	Professional	26	$39.40	$62.13	$128.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.32 / $26.47 / $187.25	Professional	TC	$14.32	$26.47	$187.25
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $61.61 / $112.88 / $195.18	Professional		$61.61	$112.88	$195.18
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $49.52 / $90.31 / $156.13	Professional	26	$49.52	$90.31	$156.13
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $11.85 / $19.73 / $36.58	Professional	TC	$11.85	$19.73	$36.58
United Facility/Professional Professional Modifier Low / Median / High Price $82.97 / $108.55 / $205.67	Professional		$82.97	$108.55	$205.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.47 / $40.33 / $85.02	Professional	26	$32.47	$40.33	$85.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.58 / $63.53 / $167.28	Professional	TC	$22.58	$63.53	$167.28
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $61.79 / $85.02 / $133.02	Professional		$61.79	$85.02	$133.02
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.22 / $39.97	Professional	26	$23.99	$28.22	$39.97
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $37.63 / $46.66 / $91.09	Professional	TC	$37.63	$46.66	$91.09