Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.92 / $23.92 / $31.68	Facility	26	$23.92	$23.92	$31.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.99 / $34.97 / $38.97	Professional		$29.99	$34.97	$38.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.54 / $23.92 / $25.97	Professional	26	$19.54	$23.92	$25.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.00 / $17.34 / $19.45	Professional	52	$15.00	$17.34	$19.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.45 / $12.16 / $13.93	Professional	TC	$10.45	$12.16	$13.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.28 / $49.00 / $49.00	Professional		$34.28	$49.00	$49.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.14 / $24.29 / $69.43	Professional	26	$19.14	$24.29	$69.43
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $8.19 / $8.19 / $8.19	Professional	52	$8.19	$8.19	$8.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.32 / $54.35 / $87.09	Professional		$33.32	$54.35	$87.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.03 / $34.29 / $53.50	Professional	26	$21.03	$34.29	$53.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.29 / $20.05 / $31.28	Professional	TC	$12.29	$20.05	$31.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $52.81 / $93.03	Professional		$38.54	$52.81	$93.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.00 / $35.10 / $58.74	Professional	26	$25.00	$35.10	$58.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.00 / $18.05 / $34.29	Professional	TC	$13.00	$18.05	$34.29
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $30.29 / $56.47 / $117.72	Professional		$30.29	$56.47	$117.72
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $37.82 / $74.29	Professional	26	$24.07	$37.82	$74.29
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $14.07 / $20.42 / $39.50	Professional	TC	$14.07	$20.42	$39.50
United Facility/Professional Professional Modifier Low / Median / High Price $34.43 / $53.09 / $93.08	Professional		$34.43	$53.09	$93.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.67 / $35.00 / $61.60	Professional	26	$23.67	$35.00	$61.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.91 / $18.02 / $31.00	Professional	TC	$11.91	$18.02	$31.00
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $26.67 / $32.00 / $46.25	Professional		$26.67	$32.00	$46.25
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $17.48 / $20.98 / $30.31	Professional	26	$17.48	$20.98	$30.31
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $8.65 / $10.38 / $15.26	Professional	TC	$8.65	$10.38	$15.26