Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $97.72 / $97.72	Facility	26	$97.72	$97.72	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $70.79 / $144.54	Professional		$34.67	$70.79	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $33.88 / $81.28	Professional	26	$19.95	$33.88	$81.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $37.15 / $97.72	Professional	TC	$12.88	$37.15	$97.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $33.88 / $56.23	Professional	26	$19.05	$33.88	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $81.28	Professional		$40.74	$57.54	$81.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.11 / $47.86	Professional	26	$23.44	$33.11	$47.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.44 / $33.88	Professional	TC	$16.98	$23.44	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $85.11 / $186.21	Professional		$50.12	$85.11	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $52.48 / $74.13	Professional	26	$28.18	$52.48	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $32.36 / $120.23	Professional	TC	$21.88	$32.36	$120.23
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $79.43 / $123.03	Professional		$30.90	$79.43	$123.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $48.98 / $74.13	Professional	26	$28.18	$48.98	$74.13
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $34.67 / $52.48	Professional	TC	$19.50	$34.67	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $75.86 / $158.49	Professional		$60.26	$75.86	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $31.62 / $70.79	Professional	26	$26.30	$31.62	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $36.31 / $95.50	Professional	TC	$24.55	$36.31	$95.50
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $17.78 / $17.78	Facility	26	$17.78	$17.78	$17.78