Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.73 / $40.27 / $64.75	Facility	26	$19.73	$40.27	$64.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.50 / $65.18 / $191.51	Professional		$55.50	$65.18	$191.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.50 / $19.73 / $53.96	Professional	26	$17.50	$19.73	$53.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.00 / $45.45 / $126.90	Professional	TC	$38.00	$45.45	$126.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.47 / $19.47 / $19.47	Professional	26	$19.47	$19.47	$19.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.52 / $104.70 / $180.76	Professional		$48.52	$104.70	$180.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.82 / $35.38 / $61.02	Professional	26	$16.82	$35.38	$61.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.70 / $66.67 / $114.99	Professional	TC	$31.70	$66.67	$114.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.56 / $110.15 / $166.44	Professional		$64.56	$110.15	$166.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.78 / $33.54 / $50.32	Professional	26	$21.78	$33.54	$50.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.55 / $72.67 / $121.04	Professional	TC	$42.55	$72.67	$121.04
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $52.38 / $91.38 / $171.46	Professional		$52.38	$91.38	$171.46
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $19.26 / $33.32 / $63.44	Professional	26	$19.26	$33.32	$63.44
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $36.29 / $64.48 / $119.54	Professional	TC	$36.29	$64.48	$119.54
United Facility/Professional Professional Modifier Low / Median / High Price $62.67 / $105.19 / $168.59	Professional		$62.67	$105.19	$168.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.21 / $31.60 / $56.91	Professional	26	$20.21	$31.60	$56.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.21 / $62.01 / $113.64	Professional	TC	$37.21	$62.01	$113.64
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $47.01 / $54.87 / $80.95	Professional		$47.01	$54.87	$80.95
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $14.09 / $17.47 / $23.60	Professional	26	$14.09	$17.47	$23.60
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $28.65 / $35.53 / $54.26	Professional	TC	$28.65	$35.53	$54.26