Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.53 / $19.53 / $44.57	Facility	26	$19.53	$19.53	$44.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.35 / $29.85 / $87.50	Professional		$26.35	$29.85	$87.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $19.53 / $54.27	Professional	26	$17.17	$19.53	$54.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $70.00 / $70.00 / $70.00	Professional	50	$70.00	$70.00	$70.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $10.32 / $44.42	Professional	TC	$9.18	$10.32	$44.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.70 / $51.17 / $150.79	Professional		$48.70	$51.17	$150.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.21 / $36.47 / $74.81	Professional	26	$24.21	$36.47	$74.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.43 / $66.87 / $102.69	Professional		$62.43	$66.87	$102.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.12 / $33.96 / $52.42	Professional	26	$28.12	$33.96	$52.42
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $93.64 / $100.30 / $154.03	Professional	50	$93.64	$100.30	$154.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.73 / $33.25 / $50.26	Professional	TC	$30.73	$33.25	$50.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.60 / $87.41 / $143.78	Professional		$47.60	$87.41	$143.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $47.34 / $96.92	Professional	26	$28.18	$47.34	$96.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.48 / $33.15 / $83.00	Professional	TC	$16.48	$33.15	$83.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $67.40 / $117.82 / $235.43	Professional		$67.40	$117.82	$235.43
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $36.29 / $64.48 / $119.54	Professional	26	$36.29	$64.48	$119.54
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $35.18 / $60.85 / $115.89	Professional	TC	$35.18	$60.85	$115.89
United Facility/Professional Professional Modifier Low / Median / High Price $36.28 / $74.20 / $158.31	Professional		$36.28	$74.20	$158.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.16 / $36.29 / $76.17	Professional	26	$25.16	$36.29	$76.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.74 / $41.50 / $63.41	Professional	TC	$13.74	$41.50	$63.41
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $29.42 / $52.13 / $79.95	Professional		$29.42	$52.13	$79.95
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $18.57 / $21.52 / $31.33	Professional	26	$18.57	$21.52	$31.33
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $10.61 / $30.61 / $42.86	Professional	TC	$10.61	$30.61	$42.86