Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.89 / $335.63 / $335.63	Facility	26	$127.89	$335.63	$335.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $475.00 / $1,320.50	Professional		$400.00	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.59 / $127.50 / $335.63	Professional	26	$118.59	$127.50	$335.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $931.29	Professional	TC	$281.41	$335.00	$931.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.55 / $708.38 / $1,015.74	Professional		$331.55	$708.38	$1,015.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.16 / $175.54 / $248.24	Professional	26	$82.16	$175.54	$248.24
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $497.32 / $1,062.57 / $1,523.61	Professional	50	$497.32	$1,062.57	$1,523.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $249.39 / $532.84 / $764.03	Professional	TC	$249.39	$532.84	$764.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.39 / $62.39 / $62.39	Facility	26	$62.39	$62.39	$62.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $459.28 / $790.24 / $1,440.32	Professional		$459.28	$790.24	$1,440.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.92 / $173.26 / $251.75	Professional	26	$104.92	$173.26	$251.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $347.89 / $603.88 / $1,101.85	Professional	TC	$347.89	$603.88	$1,101.85
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $379.56 / $674.55 / $1,250.31	Professional		$379.56	$674.55	$1,250.31
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $94.06 / $167.16 / $309.83	Professional	26	$94.06	$167.16	$309.83
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $285.50 / $507.39 / $940.47	Professional	TC	$285.50	$507.39	$940.47
United Facility/Professional Professional Modifier Low / Median / High Price $487.37 / $650.57 / $1,250.83	Professional		$487.37	$650.57	$1,250.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.14 / $115.45 / $231.00	Professional	26	$88.14	$115.45	$231.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $375.83 / $454.12 / $2,048.61	Professional	TC	$375.83	$454.12	$2,048.61
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $371.39 / $482.62 / $703.41	Professional		$371.39	$482.62	$703.41
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $68.77 / $82.52 / $111.13	Professional	26	$68.77	$82.52	$111.13
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $300.19 / $362.83 / $572.66	Professional	TC	$300.19	$362.83	$572.66