Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $331.13 / $331.13 / $331.13	Facility	26	$331.13	$331.13	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $478.63 / $1,548.82	Professional		$371.54	$478.63	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $134.90 / $281.84	Professional	26	$87.10	$134.90	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $794.33	Professional	TC	$257.04	$338.84	$794.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $794.33 / $1,258.93	Professional		$338.84	$794.33	$1,258.93
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 $257.04 / $588.84 / $933.25	Professional	TC	$257.04	$588.84	$933.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $63.10	Facility	26	$63.10	$63.10	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $794.33 / $1,445.44	Professional		$457.09	$794.33	$1,445.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $173.78 / $257.04	Professional	26	$104.71	$173.78	$257.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $602.56 / $1,230.27	Professional	TC	$354.81	$602.56	$1,230.27
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $602.56 / $954.99	Professional		$389.05	$602.56	$954.99
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $147.91 / $218.78	Professional	26	$95.50	$147.91	$218.78
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $457.09 / $707.95	Professional	TC	$302.00	$457.09	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $1,096.48	Professional		$398.11	$575.44	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $117.49 / $229.09	Professional	26	$83.18	$117.49	$229.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $457.09 / $831.76	Professional	TC	$302.00	$457.09	$831.76
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