Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.63 / $19.53 / $45.06	Facility	26	$14.63	$19.53	$45.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.53 / $62.77 / $176.58	Professional		$43.53	$62.77	$176.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $13.69 / $38.08	Professional	26	$11.07	$13.69	$38.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.56 / $48.68 / $59.90	Professional	TC	$31.56	$48.68	$59.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.01 / $39.02 / $127.56	Professional		$30.01	$39.02	$127.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $13.65 / $23.13	Professional	26	$10.03	$13.65	$23.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $24.23 / $24.23	Professional	TC	$24.23	$24.23	$24.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.85 / $61.74 / $100.10	Professional		$37.85	$61.74	$100.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $15.83 / $25.23	Professional	26	$9.69	$15.83	$25.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.14 / $45.91 / $74.43	Professional	TC	$28.14	$45.91	$74.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.69 / $76.59 / $122.21	Professional		$46.69	$76.59	$122.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.73 / $18.87 / $31.21	Professional	26	$11.73	$18.87	$31.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.96 / $56.76 / $91.00	Professional	TC	$34.96	$56.76	$91.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $42.58 / $68.08 / $133.74	Professional		$42.58	$68.08	$133.74
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $11.11 / $16.66 / $31.19	Professional	26	$11.11	$16.66	$31.19
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $32.22 / $49.82 / $99.45	Professional	TC	$32.22	$49.82	$99.45
United Facility/Professional Professional Modifier Low / Median / High Price $60.27 / $89.85 / $202.52	Professional		$60.27	$89.85	$202.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.35 / $19.55 / $35.09	Professional	26	$12.35	$19.55	$35.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.56 / $66.59 / $125.40	Professional	TC	$44.56	$66.59	$125.40
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $47.60 / $57.12 / $83.97	Professional		$47.60	$57.12	$83.97
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $12.53 / $17.32	Professional	26	$10.02	$12.53	$17.32
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $37.32 / $44.73 / $65.56	Professional	TC	$37.32	$44.73	$65.56