Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.08 / $819.99 / $1,326.08	Facility		$104.08	$819.99	$1,326.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.36 / $309.45 / $309.45	Facility	26	$58.36	$309.45	$309.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.91 / $169.66 / $295.77	Professional		$63.91	$169.66	$295.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.57 / $77.98 / $109.87	Professional	26	$36.57	$77.98	$109.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.74 / $107.78 / $185.90	Professional	TC	$27.74	$107.78	$185.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.11 / $100.57 / $177.78	Professional		$62.11	$100.57	$177.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.26 / $57.09 / $92.56	Professional	26	$35.26	$57.09	$92.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.85 / $43.48 / $70.48	Professional	TC	$26.85	$43.48	$70.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.01 / $142.44 / $357.72	Professional		$82.01	$142.44	$357.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.98 / $80.20 / $152.71	Professional	26	$45.98	$80.20	$152.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.03 / $62.23 / $213.71	Professional	TC	$36.03	$62.23	$213.71
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $65.14 / $111.85 / $219.45	Professional		$65.14	$111.85	$219.45
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $40.36 / $67.63 / $124.57	Professional	26	$40.36	$67.63	$124.57
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $30.73 / $50.66 / $94.85	Professional	TC	$30.73	$50.66	$94.85
United Facility/Professional Facility Modifier Low / Median / High Price $7,448.00 / $7,448.00 / $7,448.00	Facility		$7,448.00	$7,448.00	$7,448.00
United Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $148.97 / $432.25	Professional		$89.34	$148.97	$432.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.36 / $73.81 / $124.39	Professional	26	$48.36	$73.81	$124.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $51.36 / $200.83	Professional	TC	$36.22	$51.36	$200.83
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $53.40 / $72.09 / $217.13	Professional		$53.40	$72.09	$217.13
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $29.68 / $41.55 / $88.34	Professional	26	$29.68	$41.55	$88.34
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $29.65 / $137.65	Professional	TC	$23.72	$29.65	$137.65