Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.32 / $271.45 / $271.45	Facility	26	$104.32	$271.45	$271.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $454.64 / $1,320.50	Professional		$400.00	$454.64	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.27 / $127.50 / $271.45	Professional	26	$97.27	$127.50	$271.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $931.29	Professional	TC	$281.41	$335.00	$931.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.80 / $550.80 / $789.80	Professional		$257.80	$550.80	$789.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.95 / $143.06 / $202.31	Professional	26	$66.95	$143.06	$202.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.84 / $407.75 / $583.76	Professional	TC	$190.84	$407.75	$583.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.58 / $64.58 / $64.58	Facility	26	$64.58	$64.58	$64.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $356.92 / $625.00 / $1,101.31	Professional		$356.92	$625.00	$1,101.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.60 / $142.03 / $206.87	Professional	26	$85.60	$142.03	$206.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $266.22 / $473.58 / $901.62	Professional	TC	$266.22	$473.58	$901.62
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $295.13 / $524.50 / $972.19	Professional		$295.13	$524.50	$972.19
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $76.65 / $136.22 / $252.49	Professional	26	$76.65	$136.22	$252.49
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $218.48 / $388.28 / $719.70	Professional	TC	$218.48	$388.28	$719.70
United Facility/Professional Professional Modifier Low / Median / High Price $388.75 / $469.89 / $887.54	Professional		$388.75	$469.89	$887.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.79 / $99.53 / $221.14	Professional	26	$75.79	$99.53	$221.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $261.22 / $346.36 / $688.31	Professional	TC	$261.22	$346.36	$688.31
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $298.41 / $368.59 / $552.89	Professional		$298.41	$368.59	$552.89
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $56.46 / $67.68 / $91.55	Professional	26	$56.46	$67.68	$91.55
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $239.80 / $289.85 / $457.48	Professional	TC	$239.80	$289.85	$457.48