Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $8.32 / $19.95	Facility	26	$8.32	$8.32	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $63.10 / $186.21	Professional		$50.12	$63.10	$186.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.72 / $26.92	Professional	26	$7.94	$10.72	$26.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $48.98 / $95.50	Professional	TC	$41.69	$48.98	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $54.95 / $64.57	Professional		$46.77	$54.95	$64.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.72 / $14.45	Professional	26	$8.51	$10.72	$14.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	TC	$67.61	$67.61	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $112.20 / $162.18	Professional		$63.10	$112.20	$162.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $16.98 / $25.12	Professional	26	$9.33	$16.98	$25.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $93.33 / $134.90	Professional	TC	$53.70	$93.33	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $158.49	Professional		$61.66	$85.11	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.88 / $23.44	Professional	26	$9.55	$12.88	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $70.79 / $134.90	Professional	TC	$51.29	$70.79	$134.90
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $165.96	Professional		$69.18	$97.72	$165.96
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.45 / $24.55	Professional	26	$10.23	$14.45	$24.55
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $83.18 / $141.25	Professional	TC	$58.88	$83.18	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $87.10 / $165.96	Professional		$57.54	$87.10	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.49 / $24.55	Professional	26	$9.33	$13.49	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $74.13 / $141.25	Professional	TC	$47.86	$74.13	$141.25
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $5.50 / $6.46 / $10.96	Facility	26	$5.50	$6.46	$10.96