Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.46 / $12.46 / $17.28	Facility	26	$12.46	$12.46	$17.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.86 / $55.97 / $67.78	Professional		$46.86	$55.97	$67.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.46 / $31.24	Professional	26	$10.47	$12.46	$31.24
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.43 / $27.42 / $30.57	Professional	52	$23.43	$27.42	$30.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.39 / $43.65 / $58.82	Professional	TC	$36.39	$43.65	$58.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $14.99 / $16.50	Professional	26	$11.72	$14.99	$16.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.65 / $37.65 / $37.65	Professional	TC	$37.65	$37.65	$37.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.99 / $89.71 / $145.44	Professional		$54.99	$89.71	$145.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $18.47 / $28.81	Professional	26	$11.32	$18.47	$28.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.67 / $71.23 / $111.13	Professional	TC	$43.67	$71.23	$111.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.13 / $85.59 / $155.08	Professional		$63.13	$85.59	$155.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.54 / $19.20 / $31.63	Professional	26	$13.54	$19.20	$31.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.46 / $66.90 / $123.45	Professional	TC	$49.46	$66.90	$123.45
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $62.95 / $98.91 / $194.30	Professional		$62.95	$98.91	$194.30
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $20.04 / $40.00	Professional	26	$12.96	$20.04	$40.00
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $49.99 / $77.29 / $154.29	Professional	TC	$49.99	$77.29	$154.29
United Facility/Professional Professional Modifier Low / Median / High Price $56.35 / $87.47 / $145.54	Professional		$56.35	$87.47	$145.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.75 / $18.48 / $34.38	Professional	26	$12.75	$18.48	$34.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.03 / $78.23 / $137.62	Professional	TC	$48.03	$78.23	$137.62
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $43.69 / $52.43 / $75.92	Professional		$43.69	$52.43	$75.92
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $11.35 / $15.33	Professional	26	$9.46	$11.35	$15.33
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $33.58 / $40.29 / $55.51	Professional	TC	$33.58	$40.29	$55.51