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 / $22.22	Facility	26	$12.46	$12.46	$22.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.33 / $43.98 / $53.68	Professional		$37.33	$43.98	$53.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.46 / $17.07	Professional	26	$10.47	$12.46	$17.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.86 / $31.52 / $40.69	Professional	TC	$26.86	$31.52	$40.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.11 / $38.11 / $38.11	Professional		$38.11	$38.11	$38.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.30 / $22.88 / $37.40	Professional	26	$10.30	$22.88	$37.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.67 / $71.23 / $115.50	Professional		$43.67	$71.23	$115.50
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 $32.35 / $52.77 / $82.32	Professional	TC	$32.35	$52.77	$82.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.31 / $68.66 / $123.58	Professional		$50.31	$68.66	$123.58
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 $36.43 / $49.03 / $91.95	Professional	TC	$36.43	$49.03	$91.95
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $51.49 / $82.41 / $164.67	Professional		$51.49	$82.41	$164.67
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 $37.03 / $56.16 / $114.29	Professional	TC	$37.03	$56.16	$114.29
United Facility/Professional Professional Modifier Low / Median / High Price $44.24 / $66.44 / $115.94	Professional		$44.24	$66.44	$115.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.75 / $19.05 / $34.38	Professional	26	$12.75	$19.05	$34.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.07 / $49.60 / $89.15	Professional	TC	$33.07	$49.60	$89.15
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $34.92 / $41.90 / $61.60	Professional		$34.92	$41.90	$61.60
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 $25.28 / $30.29 / $40.99	Professional	TC	$25.28	$30.29	$40.99