Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.89 / $407.65 / $1,008.98	Facility		$34.89	$407.65	$1,008.98
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.83 / $20.09 / $56.05	Facility	26	$14.83	$20.09	$56.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $34.90 / $95.14	Professional		$24.85	$34.90	$95.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.83 / $36.46	Professional	26	$10.72	$14.83	$36.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $20.07 / $61.66	Professional	TC	$14.13	$20.07	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.85 / $28.85 / $37.82	Professional		$28.85	$28.85	$37.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $17.89 / $42.61	Professional	26	$10.47	$17.89	$42.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $157.51 / $197.94 / $219.89	Facility		$157.51	$197.94	$219.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $54.61 / $76.56	Professional		$37.20	$54.61	$76.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.94 / $19.00 / $26.63	Professional	26	$12.94	$19.00	$26.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.26 / $35.61 / $49.94	Professional	TC	$24.26	$35.61	$49.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $202.64 / $202.64 / $202.64	Facility		$202.64	$202.64	$202.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.24 / $72.51 / $121.18	Professional		$45.24	$72.51	$121.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.73 / $28.22 / $41.14	Professional	26	$16.73	$28.22	$41.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.58 / $44.56 / $79.08	Professional	TC	$27.58	$44.56	$79.08
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $31.23 / $70.19 / $131.41	Professional		$31.23	$70.19	$131.41
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $14.81 / $26.50 / $48.79	Professional	26	$14.81	$26.50	$48.79
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $27.77 / $52.91 / $91.48	Professional	TC	$27.77	$52.91	$91.48
United Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $45.89 / $77.83	Professional		$37.04	$45.89	$77.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.76 / $19.39 / $38.82	Professional	26	$15.76	$19.39	$38.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.04 / $30.31 / $58.19	Professional	TC	$20.04	$30.31	$58.19
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $29.03 / $33.90 / $51.21	Professional		$29.03	$33.90	$51.21
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $11.06 / $13.71 / $18.05	Professional	26	$11.06	$13.71	$18.05
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $16.17 / $20.67 / $28.93	Professional	TC	$16.17	$20.67	$28.93