Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.64 / $29.46 / $29.47	Facility	26	$27.64	$29.46	$29.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.01 / $52.97 / $58.72	Professional		$36.01	$52.97	$58.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.69 / $27.39 / $31.55	Professional	26	$20.69	$27.39	$31.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.74 / $25.58 / $28.14	Professional	TC	$15.74	$25.58	$28.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.45 / $45.09 / $102.85	Professional		$33.45	$45.09	$102.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.05 / $31.79 / $64.89	Professional	26	$21.05	$31.79	$64.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.29 / $37.29 / $37.29	Professional	TC	$37.29	$37.29	$37.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.70 / $64.79 / $90.90	Professional		$42.70	$64.79	$90.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.49 / $40.36 / $57.09	Professional	26	$27.49	$40.36	$57.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.20 / $24.43 / $36.88	Professional	TC	$15.20	$24.43	$36.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $39.28 / $39.28	Professional		$39.28	$39.28	$39.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $25.29 / $25.29	Professional	26	$25.29	$25.29	$25.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $13.99 / $13.99	Professional	TC	$13.99	$13.99	$13.99
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $24.81 / $38.36 / $76.58	Professional		$24.81	$38.36	$76.58
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $15.92 / $28.29 / $52.44	Professional	26	$15.92	$28.29	$52.44
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $8.89 / $13.16 / $23.55	Professional	TC	$8.89	$13.16	$23.55
United Facility/Professional Professional Modifier Low / Median / High Price $57.32 / $71.19 / $106.29	Professional		$57.32	$71.19	$106.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.47 / $38.49 / $81.06	Professional	26	$31.47	$38.49	$81.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.71 / $34.22 / $71.00	Professional	TC	$22.71	$34.22	$71.00
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $43.32 / $58.48 / $7,080.00	Professional		$43.32	$58.48	$7,080.00
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $26.90 / $40.61	Professional	26	$22.87	$26.90	$40.61
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $23.70 / $35.79	Professional	TC	$20.14	$23.70	$35.79