Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Facility	26	$104.71	$104.71	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $269.15 / $478.63	Professional		$204.17	$269.15	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $120.23 / $251.19	Professional	26	$87.10	$120.23	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $131.83 / $223.87	Professional	TC	$100.00	$131.83	$223.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $645.65 / $954.99	Professional		$218.78	$645.65	$954.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $177.83 / $257.04	Professional	26	$109.65	$177.83	$257.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $467.74 / $707.95	Professional	TC	$107.15	$467.74	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $851.14 / $1,412.54	Professional		$501.19	$851.14	$1,412.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $208.93 / $338.84	Professional	26	$125.89	$208.93	$338.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $630.96 / $1,071.52	Professional	TC	$371.54	$630.96	$1,071.52
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $741.31 / $1,096.48	Professional		$478.63	$741.31	$1,096.48
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $199.53 / $295.12	Professional	26	$128.82	$199.53	$295.12
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $537.03 / $794.33	Professional	TC	$346.74	$537.03	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $645.65 / $1,288.25	Professional		$446.68	$645.65	$1,288.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $158.49 / $302.00	Professional	26	$109.65	$158.49	$302.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $489.78 / $977.24	Professional	TC	$331.13	$489.78	$977.24
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $85.11 / $85.11	Facility	26	$72.44	$85.11	$85.11