Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.42 / $39.42 / $70.40	Facility	26	$39.42	$39.42	$70.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.14 / $130.40 / $306.37	Professional		$107.14	$130.40	$306.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.27 / $36.00 / $72.55	Professional	26	$29.27	$36.00	$72.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.87 / $87.07 / $136.21	Professional	TC	$77.87	$87.07	$136.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.78 / $129.94 / $296.36	Professional		$93.78	$129.94	$296.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.25 / $38.85 / $121.83	Professional	26	$28.25	$38.85	$121.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $208.45 / $208.45 / $208.45	Professional	TC	$208.45	$208.45	$208.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.95 / $179.04 / $256.72	Professional		$121.95	$179.04	$256.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.88 / $54.14 / $76.56	Professional	26	$36.88	$54.14	$76.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.07 / $124.90 / $176.88	Professional	TC	$85.07	$124.90	$176.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.41 / $259.89 / $383.41	Professional		$162.41	$259.89	$383.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.22 / $76.34 / $114.00	Professional	26	$47.22	$76.34	$114.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.24 / $181.02 / $269.41	Professional	TC	$114.24	$181.02	$269.41
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $139.60 / $230.13 / $459.86	Professional		$139.60	$230.13	$459.86
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $42.21 / $69.44 / $139.04	Professional	26	$42.21	$69.44	$139.04
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $97.39 / $171.05 / $320.81	Professional	TC	$97.39	$171.05	$320.81
United Facility/Professional Professional Modifier Low / Median / High Price $156.80 / $177.35 / $355.26	Professional		$156.80	$177.35	$355.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.12 / $54.05 / $102.11	Professional	26	$44.12	$54.05	$102.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.42 / $125.53 / $253.36	Professional	TC	$109.42	$125.53	$253.36
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $107.30 / $144.86 / $3,000.00	Professional		$107.30	$144.86	$3,000.00
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $31.19 / $36.69 / $55.41	Professional	26	$31.19	$36.69	$55.41
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $75.34 / $88.64 / $133.87	Professional	TC	$75.34	$88.64	$133.87