Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.69 / $348.97 / $348.97	Facility	26	$133.69	$348.97	$348.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.00 / $366.87 / $444.40	Professional		$288.00	$366.87	$444.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.67 / $100.82 / $123.54	Professional	26	$87.67	$100.82	$123.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $200.28 / $263.95 / $320.86	Professional	TC	$200.28	$263.95	$320.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $332.05 / $543.52 / $794.34	Professional		$332.05	$543.52	$794.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.48 / $157.68 / $238.69	Professional	26	$86.48	$157.68	$238.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $195.90 / $380.20 / $555.66	Professional	TC	$195.90	$380.20	$555.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $359.99 / $680.79 / $1,029.20	Professional		$359.99	$680.79	$1,029.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.84 / $180.26 / $276.85	Professional	26	$105.84	$180.26	$276.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $258.37 / $497.66 / $752.35	Professional	TC	$258.37	$497.66	$752.35
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $308.08 / $611.19 / $1,014.88	Professional		$308.08	$611.19	$1,014.88
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $92.58 / $183.66 / $304.97	Professional	26	$92.58	$183.66	$304.97
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $215.51 / $427.53 / $709.91	Professional	TC	$215.51	$427.53	$709.91
United Facility/Professional Professional Modifier Low / Median / High Price $398.57 / $581.72 / $1,136.71	Professional		$398.57	$581.72	$1,136.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $115.08 / $152.29 / $274.85	Professional	26	$115.08	$152.29	$274.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $283.49 / $385.98 / $677.11	Professional	TC	$283.49	$385.98	$677.11
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $233.66 / $280.39 / $412.18	Professional		$233.66	$280.39	$412.18
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $65.65 / $79.44 / $105.69	Professional	26	$65.65	$79.44	$105.69
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $168.01 / $201.61 / $285.66	Professional	TC	$168.01	$201.61	$285.66