Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $52.48 / $89.13	Facility	26	$28.84	$52.48	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $66.07 / $194.98	Professional		$56.23	$66.07	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.90 / $89.13	Professional	26	$25.12	$38.90	$89.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.88 / $85.11	Professional	TC	$28.84	$33.88	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Professional		$67.61	$67.61	$67.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.20 / $33.11	Professional	26	$30.20	$30.20	$33.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $125.89 / $181.97	Professional		$69.18	$125.89	$181.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $53.70 / $77.62	Professional	26	$28.84	$53.70	$77.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $70.79 / $104.71	Professional	TC	$40.74	$70.79	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $93.33 / $213.80	Professional		$67.61	$93.33	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $42.66 / $72.44	Professional	26	$29.51	$42.66	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $51.29 / $112.20	Professional	TC	$35.48	$51.29	$112.20
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $104.71 / $181.97	Professional		$61.66	$104.71	$181.97
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $43.65 / $75.86	Professional	26	$31.62	$43.65	$75.86
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $64.57 / $107.15	Professional	TC	$44.67	$64.57	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $93.33 / $190.55	Professional		$61.66	$93.33	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $42.66 / $77.62	Professional	26	$29.51	$42.66	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $51.29 / $102.33	Professional	TC	$32.36	$51.29	$102.33
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $19.95 / $33.88	Facility	26	$16.98	$19.95	$33.88