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 $190.55 / $275.42 / $645.65	Professional		$190.55	$275.42	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $69.18 / $141.25	Professional	26	$51.29	$69.18	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $213.80 / $354.81	Professional	TC	$141.25	$213.80	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $457.09 / $660.69	Professional		$194.98	$457.09	$660.69
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 $138.04 / $323.59 / $512.86	Professional	TC	$138.04	$323.59	$512.86
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 $269.15 / $501.19 / $954.99	Professional		$269.15	$501.19	$954.99
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 $194.98 / $354.81 / $776.25	Professional	TC	$194.98	$354.81	$776.25
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $354.81 / $537.03	Professional		$223.87	$354.81	$537.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $100.00 / $147.91	Professional	26	$64.57	$100.00	$147.91
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $257.04 / $371.54	Professional	TC	$162.18	$257.04	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $363.08 / $691.83	Professional		$234.42	$363.08	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $81.28 / $151.36	Professional	26	$56.23	$81.28	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $263.03 / $489.78	Professional	TC	$169.82	$263.03	$489.78
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