Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.55 / $99.72 / $99.72	Facility	26	$27.55	$99.72	$99.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.30 / $101.09 / $281.05	Professional		$80.30	$101.09	$281.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.35 / $25.02 / $71.86	Professional	26	$21.35	$25.02	$71.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.95 / $74.40 / $207.77	Professional	TC	$58.95	$74.40	$207.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.98 / $177.61 / $251.17	Professional		$120.98	$177.61	$251.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.85 / $39.42 / $55.74	Professional	26	$26.85	$39.42	$55.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.13 / $138.19 / $195.09	Professional	TC	$94.13	$138.19	$195.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.11 / $221.39 / $395.50	Professional		$160.11	$221.39	$395.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.97 / $55.12 / $83.90	Professional	26	$33.97	$55.12	$83.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.14 / $161.72 / $311.58	Professional	TC	$126.14	$161.72	$311.58
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $138.49 / $246.12 / $456.20	Professional		$138.49	$246.12	$456.20
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $30.73 / $53.16 / $101.23	Professional	26	$30.73	$53.16	$101.23
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $107.76 / $191.51 / $354.97	Professional	TC	$107.76	$191.51	$354.97
United Facility/Professional Professional Modifier Low / Median / High Price $121.61 / $160.90 / $277.91	Professional		$121.61	$160.90	$277.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.80 / $39.29 / $77.43	Professional	26	$26.80	$39.29	$77.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.73 / $127.66 / $205.30	Professional	TC	$94.73	$127.66	$205.30
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $89.73 / $113.87 / $174.60	Professional		$89.73	$113.87	$174.60
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $22.63 / $26.62 / $36.69	Professional	26	$22.63	$26.62	$36.69
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $65.88 / $87.61 / $122.64	Professional	TC	$65.88	$87.61	$122.64