Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.27 / $8.27 / $12.66	Facility	26	$8.27	$8.27	$12.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.67 / $56.39 / $126.45	Professional		$48.67	$56.39	$126.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $8.66 / $20.73	Professional	26	$7.83	$8.66	$20.73
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.34 / $28.20 / $30.61	Professional	52	$24.34	$28.20	$30.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.84 / $47.73 / $71.18	Professional	TC	$40.84	$47.73	$71.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $11.12 / $17.05	Professional	26	$8.69	$11.12	$17.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.45 / $39.45 / $39.45	Professional	TC	$39.45	$39.45	$39.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.34 / $88.65 / $143.72	Professional		$54.34	$88.65	$143.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $13.72 / $21.40	Professional	26	$8.41	$13.72	$21.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.93 / $74.93 / $116.89	Professional	TC	$45.93	$74.93	$116.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.03 / $88.33 / $157.28	Professional		$64.03	$88.33	$157.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $13.75 / $23.48	Professional	26	$9.86	$13.75	$23.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.47 / $73.98 / $133.80	Professional	TC	$54.47	$73.98	$133.80
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $62.21 / $96.19 / $192.01	Professional		$62.21	$96.19	$192.01
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $14.89 / $29.72	Professional	26	$9.63	$14.89	$29.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $52.58 / $81.42 / $162.29	Professional	TC	$52.58	$81.42	$162.29
United Facility/Professional Professional Modifier Low / Median / High Price $59.46 / $88.59 / $156.38	Professional		$59.46	$88.59	$156.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.51 / $13.74 / $23.68	Professional	26	$9.51	$13.74	$23.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.99 / $76.93 / $134.78	Professional	TC	$49.99	$76.93	$134.78
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $45.53 / $53.18 / $80.31	Professional		$45.53	$53.18	$80.31
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $6.97 / $8.36 / $11.31	Professional	26	$6.97	$8.36	$11.31
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $38.22 / $45.82 / $61.98	Professional	TC	$38.22	$45.82	$61.98