Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.70 / $4.40 / $11.99	Facility	26	$3.70	$4.40	$11.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.01 / $37.31 / $111.81	Professional		$27.01	$37.31	$111.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.24 / $3.70 / $9.11	Professional	26	$3.24	$3.70	$9.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.51 / $14.05 / $18.66	Professional	52	$13.51	$14.05	$18.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.78 / $33.61 / $93.82	Professional	TC	$23.78	$33.61	$93.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $53.77 / $53.77	Professional		$53.77	$53.77	$53.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.05 / $3.37 / $9.63	Professional	26	$3.05	$3.37	$9.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $48.22 / $81.94	Professional		$22.00	$48.22	$81.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.91 / $6.11 / $10.58	Professional	26	$2.91	$6.11	$10.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $40.13 / $69.27	Professional	TC	$19.07	$40.13	$69.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.47 / $50.71 / $125.88	Professional		$29.47	$50.71	$125.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.77 / $5.95 / $9.18	Professional	26	$3.77	$5.95	$9.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.65 / $43.97 / $121.42	Professional	TC	$25.65	$43.97	$121.42
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $25.18 / $44.22 / $77.72	Professional		$25.18	$44.22	$77.72
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $3.33 / $5.76 / $10.28	Professional	26	$3.33	$5.76	$10.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $21.85 / $38.83 / $71.98	Professional	TC	$21.85	$38.83	$71.98
United Facility/Professional Professional Modifier Low / Median / High Price $26.22 / $48.74 / $166.58	Professional		$26.22	$48.74	$166.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.64 / $5.79 / $11.04	Professional	26	$3.64	$5.79	$11.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.22 / $38.22 / $159.22	Professional	TC	$26.22	$38.22	$159.22
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $22.13 / $27.69 / $40.42	Professional		$22.13	$27.69	$40.42
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $2.44 / $3.13 / $4.62	Professional	26	$2.44	$3.13	$4.62
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $26.05 / $31.26 / $35.17	Professional	52	$26.05	$31.26	$35.17
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $17.68 / $21.92 / $36.90	Professional	TC	$17.68	$21.92	$36.90