Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.31 / $167.31 / $167.31	Facility	26	$167.31	$167.31	$167.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $340.48 / $439.93 / $439.93	Professional		$340.48	$439.93	$439.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.95 / $152.03 / $152.03	Professional	26	$109.95	$152.03	$152.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $230.53 / $287.89 / $289.19	Professional	TC	$230.53	$287.89	$289.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $392.69 / $667.00 / $974.79	Professional		$392.69	$667.00	$974.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $108.72 / $199.02 / $298.83	Professional	26	$108.72	$199.02	$298.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $232.96 / $462.52 / $675.96	Professional	TC	$232.96	$462.52	$675.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.64 / $825.95 / $1,248.66	Professional		$441.64	$825.95	$1,248.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $132.44 / $226.30 / $345.78	Professional	26	$132.44	$226.30	$345.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.19 / $568.94 / $902.87	Professional	TC	$309.19	$568.94	$902.87
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $378.08 / $754.99 / $1,345.17	Professional		$378.08	$754.99	$1,345.17
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $115.90 / $220.81 / $381.79	Professional	26	$115.90	$220.81	$381.79
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $262.17 / $520.09 / $863.61	Professional	TC	$262.17	$520.09	$863.61
United Facility/Professional Professional Modifier Low / Median / High Price $458.07 / $588.58 / $1,142.21	Professional		$458.07	$588.58	$1,142.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $145.85 / $186.97 / $684.18	Professional	26	$145.85	$186.97	$684.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $292.42 / $465.93 / $803.63	Professional	TC	$292.42	$465.93	$803.63
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $235.24 / $327.20 / $494.17	Professional		$235.24	$327.20	$494.17
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $83.14 / $99.77 / $133.85	Professional	26	$83.14	$99.77	$133.85
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $185.78 / $230.10 / $317.14	Professional	TC	$185.78	$230.10	$317.14