Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $194.98 / $331.13	Facility	26	$128.82	$194.98	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $426.58 / $977.24	Professional		$295.12	$426.58	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $138.04 / $281.84	Professional	26	$87.10	$138.04	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $302.00 / $588.84	Professional	TC	$208.93	$302.00	$588.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $630.96 / $912.01	Professional		$269.15	$630.96	$912.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $190.55 / $275.42	Professional	26	$81.28	$190.55	$275.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $436.52 / $691.83	Professional	TC	$186.21	$436.52	$691.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	26	$107.15	$107.15	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $645.65 / $1,380.38	Professional		$371.54	$645.65	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $173.78 / $263.03	Professional	26	$104.71	$173.78	$263.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $457.09 / $1,174.90	Professional	TC	$263.03	$457.09	$1,174.90
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $489.78 / $776.25	Professional		$309.03	$489.78	$776.25
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $147.91 / $229.09	Professional	26	$95.50	$147.91	$229.09
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $338.84 / $524.81	Professional	TC	$218.78	$338.84	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $501.19 / $912.01	Professional		$316.23	$501.19	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $120.23 / $239.88	Professional	26	$81.28	$120.23	$239.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $346.74 / $630.96	Professional	TC	$218.78	$346.74	$630.96
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $63.10 / $63.10	Facility	26	$53.70	$63.10	$63.10