Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.80 / $88.36 / $88.36	Facility	26	$28.80	$88.36	$88.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $61.69 / $119.92	Professional		$52.47	$61.69	$119.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.65 / $28.80 / $67.56	Professional	26	$24.65	$28.80	$67.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.81 / $32.89 / $60.51	Professional	TC	$27.81	$32.89	$60.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.25 / $54.25 / $54.25	Professional		$54.25	$54.25	$54.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.29 / $30.29 / $30.29	Professional	26	$30.29	$30.29	$30.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.46 / $100.26 / $162.56	Professional		$61.46	$100.26	$162.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.20 / $42.74 / $66.67	Professional	26	$26.20	$42.74	$66.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.26 / $57.52 / $89.73	Professional	TC	$35.26	$57.52	$89.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.51 / $99.42 / $192.50	Professional		$68.51	$99.42	$192.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.18 / $44.99 / $73.25	Professional	26	$31.18	$44.99	$73.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.86 / $53.29 / $108.16	Professional	TC	$36.86	$53.29	$108.16
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $59.26 / $104.17 / $217.17	Professional		$59.26	$104.17	$217.17
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $29.99 / $47.12 / $92.56	Professional	26	$29.99	$47.12	$92.56
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $40.36 / $63.42 / $124.57	Professional	TC	$40.36	$63.42	$124.57
United Facility/Professional Professional Modifier Low / Median / High Price $63.28 / $89.65 / $200.90	Professional		$63.28	$89.65	$200.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $42.79 / $84.00	Professional	26	$29.51	$42.79	$84.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.32 / $48.60 / $90.58	Professional	TC	$32.32	$48.60	$90.58
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $46.79 / $56.15 / $82.54	Professional		$46.79	$56.15	$82.54
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $21.91 / $26.29 / $35.28	Professional	26	$21.91	$26.29	$35.28
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $24.70 / $29.61 / $43.89	Professional	TC	$24.70	$29.61	$43.89