Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.00 / $151.88 / $151.88	Facility	26	$60.00	$151.88	$151.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.80 / $119.57 / $140.18	Professional		$70.80	$119.57	$140.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.19 / $69.45 / $100.62	Professional	TC	$39.19	$69.45	$100.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.80 / $153.87 / $220.63	Professional		$104.80	$153.87	$220.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.31 / $97.35 / $137.66	Professional	TC	$66.31	$97.35	$137.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.92 / $49.92 / $49.92	Facility	26	$49.92	$49.92	$49.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.78 / $227.06 / $338.70	Professional		$134.78	$227.06	$338.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.08 / $148.88 / $236.22	Professional	TC	$89.08	$148.88	$236.22
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $119.98 / $213.23 / $395.23	Professional		$119.98	$213.23	$395.23
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $75.91 / $134.91 / $250.06	Professional	TC	$75.91	$134.91	$250.06
United Facility/Professional Professional Modifier Low / Median / High Price $129.19 / $156.12 / $252.89	Professional		$129.19	$156.12	$252.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.48 / $109.58 / $287.04	Professional	TC	$78.48	$109.58	$287.04
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $81.73 / $89.91 / $114.44	Professional		$81.73	$89.91	$114.44
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $50.03 / $55.43 / $60.47	Professional	TC	$50.03	$55.43	$60.47