Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.01 / $335.67 / $335.67	Facility	26	$127.01	$335.67	$335.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $475.00 / $1,320.50	Professional		$400.00	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $127.50 / $335.67	Professional	26	$111.15	$127.50	$335.67
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 $327.67 / $700.08 / $1,003.84	Professional		$327.67	$700.08	$1,003.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.51 / $174.16 / $246.29	Professional	26	$81.51	$174.16	$246.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $246.16 / $525.92 / $754.13	Professional	TC	$246.16	$525.92	$754.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.84 / $63.84 / $63.84	Facility	26	$63.84	$63.84	$63.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $453.99 / $785.75 / $1,437.79	Professional		$453.99	$785.75	$1,437.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.29 / $173.36 / $250.89	Professional	26	$104.29	$173.36	$250.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $343.37 / $600.08 / $1,094.82	Professional	TC	$343.37	$600.08	$1,094.82
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $375.11 / $666.65 / $1,235.65	Professional		$375.11	$666.65	$1,235.65
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $93.32 / $165.85 / $307.41	Professional	26	$93.32	$165.85	$307.41
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $281.80 / $500.82 / $928.28	Professional	TC	$281.80	$500.82	$928.28
United Facility/Professional Professional Modifier Low / Median / High Price $484.22 / $546.17 / $1,091.25	Professional		$484.22	$546.17	$1,091.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.38 / $120.37 / $241.52	Professional	26	$83.38	$120.37	$241.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $347.79 / $411.65 / $849.73	Professional	TC	$347.79	$411.65	$849.73
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $370.10 / $484.20 / $700.97	Professional		$370.10	$484.20	$700.97
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $68.77 / $82.58 / $110.71	Professional	26	$68.77	$82.58	$110.71
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $299.16 / $361.60 / $570.72	Professional	TC	$299.16	$361.60	$570.72