Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.39 / $16.95 / $38.78	Facility	26	$12.39	$16.95	$38.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.15 / $116.00 / $321.27	Professional		$89.15	$116.00	$321.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.57 / $12.39 / $31.96	Professional	26	$11.57	$12.39	$31.96
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.49 / $46.49 / $58.00	Professional	52	$46.49	$46.49	$58.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.41 / $103.60 / $289.31	Professional	TC	$81.41	$103.60	$289.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.67 / $60.67 / $60.67	Professional		$60.67	$60.67	$60.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.43 / $9.31 / $37.15	Professional	26	$8.43	$9.31	$37.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.25 / $89.92 / $157.05	Professional		$79.25	$89.92	$157.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $12.85 / $20.59	Professional	26	$11.32	$12.85	$20.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.93 / $77.06 / $134.80	Professional	TC	$67.93	$77.06	$134.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.32 / $158.38 / $228.34	Professional		$93.32	$158.38	$228.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.95 / $21.28 / $31.42	Professional	26	$12.95	$21.28	$31.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.37 / $135.93 / $196.92	Professional	TC	$80.37	$135.93	$196.92
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $90.72 / $160.88 / $298.83	Professional		$90.72	$160.88	$298.83
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $22.42 / $40.00	Professional	26	$12.96	$22.42	$40.00
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $77.76 / $134.51 / $240.01	Professional	TC	$77.76	$134.51	$240.01
United Facility/Professional Professional Modifier Low / Median / High Price $99.01 / $150.47 / $294.14	Professional		$99.01	$150.47	$294.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.10 / $19.14 / $42.91	Professional	26	$13.10	$19.14	$42.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.60 / $133.44 / $249.18	Professional	TC	$87.60	$133.44	$249.18
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $75.65 / $94.63 / $130.25	Professional		$75.65	$94.63	$130.25
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $11.54 / $15.60	Professional	26	$9.69	$11.54	$15.60
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $24.84 / $29.81 / $33.53	Professional	52	$24.84	$29.81	$33.53
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $59.08 / $73.26 / $111.90	Professional	TC	$59.08	$73.26	$111.90