Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.39 / $26.09 / $49.55	Facility	26	$14.39	$26.09	$49.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.16 / $39.34 / $107.69	Professional		$28.16	$39.34	$107.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $12.59 / $37.58	Professional	26	$10.83	$12.59	$37.58
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.93 / $19.67 / $25.35	Professional	52	$13.93	$19.67	$25.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $24.95 / $70.11	Professional	TC	$17.32	$24.95	$70.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.51 / $76.51 / $76.51	Professional		$76.51	$76.51	$76.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.41 / $16.22 / $16.22	Professional	26	$14.41	$16.22	$16.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.99 / $64.59 / $91.34	Professional		$43.99	$64.59	$91.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.62 / $18.52 / $26.19	Professional	26	$12.62	$18.52	$26.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.38 / $46.07 / $65.03	Professional	TC	$31.38	$46.07	$65.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.12 / $84.01 / $138.63	Professional		$56.12	$84.01	$138.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.47 / $26.10 / $39.38	Professional	26	$16.47	$26.10	$39.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.26 / $53.46 / $99.66	Professional	TC	$40.26	$53.46	$99.66
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $51.22 / $99.90 / $165.89	Professional		$51.22	$99.90	$165.89
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $14.44 / $24.98 / $47.57	Professional	26	$14.44	$24.98	$47.57
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $35.92 / $59.09 / $118.32	Professional	TC	$35.92	$59.09	$118.32
United Facility/Professional Professional Modifier Low / Median / High Price $44.77 / $58.18 / $154.37	Professional		$44.77	$58.18	$154.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.08 / $17.67 / $39.54	Professional	26	$13.08	$17.67	$39.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.68 / $39.67 / $58.29	Professional	TC	$30.68	$39.67	$58.29
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $31.65 / $41.08 / $62.04	Professional		$31.65	$41.08	$62.04
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $10.58 / $12.59 / $17.03	Professional	26	$10.58	$12.59	$17.03
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $22.13 / $28.28 / $39.58	Professional	TC	$22.13	$28.28	$39.58