Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $52.48 / $100.00	Facility	26	$27.54	$52.48	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $120.23 / $269.15	Professional		$79.43	$120.23	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $26.92 / $69.18	Professional	26	$20.89	$26.92	$69.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $91.20 / $213.80	Professional	TC	$58.88	$91.20	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $194.98 / $257.04	Professional		$131.83	$194.98	$257.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $43.65 / $63.10	Professional	26	$28.18	$43.65	$63.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $151.36 / $199.53	Professional	TC	$104.71	$151.36	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $199.53 / $398.11	Professional		$144.54	$199.53	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $54.95 / $81.28	Professional	26	$33.88	$54.95	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $154.88 / $316.23	Professional	TC	$107.15	$154.88	$316.23
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $239.88 / $363.08	Professional		$154.88	$239.88	$363.08
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $51.29 / $75.86	Professional	26	$33.11	$51.29	$75.86
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $186.21 / $281.84	Professional	TC	$120.23	$186.21	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $169.82 / $331.13	Professional		$120.23	$169.82	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $38.90 / $74.13	Professional	26	$26.92	$38.90	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $131.83 / $251.19	Professional	TC	$87.10	$131.83	$251.19
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $20.89 / $20.89	Facility	26	$17.78	$20.89	$20.89