Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $288.40 / $588.84	Professional		$223.87	$288.40	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $69.18 / $141.25	Professional	26	$52.48	$69.18	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $218.78 / $436.52	Professional	TC	$169.82	$218.78	$436.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $575.44 / $851.14	Professional		$234.42	$575.44	$851.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $128.82 / $186.21	Professional	26	$56.23	$128.82	$186.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $446.68 / $660.69	Professional	TC	$177.83	$446.68	$660.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $588.84 / $933.25	Professional		$338.84	$588.84	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $117.49 / $177.83	Professional	26	$72.44	$117.49	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $467.74 / $776.25	Professional	TC	$263.03	$467.74	$776.25
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $457.09 / $676.08	Professional		$295.12	$457.09	$676.08
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $102.33 / $147.91	Professional	26	$64.57	$102.33	$147.91
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $354.81 / $512.86	Professional	TC	$229.09	$354.81	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $407.38 / $724.44	Professional		$281.84	$407.38	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $81.28 / $151.36	Professional	26	$57.54	$81.28	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $323.59 / $549.54	Professional	TC	$223.87	$323.59	$549.54
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $42.66 / $42.66	Facility	26	$36.31	$42.66	$42.66