Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $149.28 / $149.28 / $163.72	Facility	26	$149.28	$149.28	$163.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.81 / $436.18 / $441.05	Professional		$312.81	$436.18	$441.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.87 / $149.28 / $149.29	Professional	26	$105.87	$149.28	$149.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $150.02 / $150.02 / $150.02	Professional	52	$150.02	$150.02	$150.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $206.93 / $286.89 / $310.02	Professional	TC	$206.93	$286.89	$310.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $399.38 / $663.73 / $970.01	Professional		$399.38	$663.73	$970.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.59 / $193.94 / $292.14	Professional	26	$106.59	$193.94	$292.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $237.09 / $463.83 / $677.87	Professional	TC	$237.09	$463.83	$677.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $439.69 / $823.96 / $1,245.64	Professional		$439.69	$823.96	$1,245.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.62 / $223.43 / $338.17	Professional	26	$129.62	$223.43	$338.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $310.07 / $579.00 / $907.47	Professional	TC	$310.07	$579.00	$907.47
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $376.22 / $746.35 / $1,338.55	Professional		$376.22	$746.35	$1,338.55
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $113.31 / $224.78 / $373.25	Professional	26	$113.31	$224.78	$373.25
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $262.91 / $521.55 / $866.05	Professional	TC	$262.91	$521.55	$866.05
United Facility/Professional Professional Modifier Low / Median / High Price $456.71 / $595.90 / $1,156.43	Professional		$456.71	$595.90	$1,156.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $142.99 / $172.45 / $341.52	Professional	26	$142.99	$172.45	$341.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $330.89 / $467.24 / $814.91	Professional	TC	$330.89	$467.24	$814.91
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $235.15 / $331.42 / $500.54	Professional		$235.15	$331.42	$500.54
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $81.54 / $97.85 / $131.27	Professional	26	$81.54	$97.85	$131.27
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $186.89 / $233.61 / $325.54	Professional	TC	$186.89	$233.61	$325.54