Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.10 / $30.10 / $43.00	Facility	26	$30.10	$30.10	$43.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.96 / $50.14 / $64.72	Professional		$42.96	$50.14	$64.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.14 / $26.57 / $53.14	Professional	26	$22.14	$26.57	$53.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.10 / $47.78 / $47.78	Professional	52	$23.10	$47.78	$47.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.82 / $23.70 / $37.32	Professional	TC	$20.82	$23.70	$37.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.53 / $53.79 / $105.00	Professional		$39.53	$53.79	$105.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.05 / $31.73 / $55.00	Professional	26	$21.05	$31.73	$55.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.12 / $57.12 / $57.12	Professional	TC	$57.12	$57.12	$57.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.85 / $50.78 / $70.44	Professional		$39.85	$50.78	$70.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.57 / $27.49 / $38.13	Professional	26	$21.57	$27.49	$38.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.27 / $23.29 / $32.29	Professional	TC	$18.27	$23.29	$32.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.51 / $106.54 / $158.06	Professional		$66.51	$106.54	$158.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.77 / $57.12 / $83.98	Professional	26	$35.77	$57.12	$83.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.91 / $49.70 / $74.06	Professional	TC	$30.91	$49.70	$74.06
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $18.50 / $44.36 / $90.28	Professional		$18.50	$44.36	$90.28
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $15.92 / $28.29 / $52.44	Professional	26	$15.92	$28.29	$52.44
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $13.33 / $23.06 / $43.91	Professional	TC	$13.33	$23.06	$43.91
United Facility/Professional Professional Modifier Low / Median / High Price $63.56 / $75.14 / $189.98	Professional		$63.56	$75.14	$189.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.07 / $37.21 / $73.81	Professional	26	$19.07	$37.21	$73.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.39 / $32.86 / $57.64	Professional	TC	$27.39	$32.86	$57.64
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $43.32 / $50.60 / $76.42	Professional		$43.32	$50.60	$76.42
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $26.90 / $38.17	Professional	26	$22.87	$26.90	$38.17
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $23.70 / $34.56	Professional	TC	$20.14	$23.70	$34.56