Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $66.07 / $66.07	Facility	26	$66.07	$66.07	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $52.48 / $123.03	Professional		$30.20	$52.48	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $22.91 / $63.10	Professional	26	$19.05	$22.91	$63.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $30.90 / $67.61	Professional	TC	$8.91	$30.90	$67.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $19.50	Professional	26	$19.50	$19.50	$19.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $128.82 / $190.55	Professional		$52.48	$128.82	$190.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $48.98 / $74.13	Professional	26	$20.42	$48.98	$74.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $75.86 / $114.82	Professional	TC	$32.36	$75.86	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $77.62 / $158.49	Professional		$45.71	$77.62	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $37.15 / $60.26	Professional	26	$23.99	$37.15	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $46.77 / $95.50	Professional	TC	$14.79	$46.77	$95.50
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $79.43 / $144.54	Professional		$43.65	$79.43	$144.54
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $33.11 / $53.70	Professional	26	$22.39	$33.11	$53.70
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $52.48 / $89.13	Professional	TC	$35.48	$52.48	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $72.44 / $141.25	Professional		$40.74	$72.44	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $33.88 / $61.66	Professional	26	$21.38	$33.88	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $39.81 / $83.18	Professional	TC	$14.79	$39.81	$83.18
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $15.49 / $26.30	Facility	26	$13.18	$15.49	$26.30