Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.75 / $105.75 / $171.29	Facility	26	$105.75	$105.75	$171.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.27 / $260.36 / $290.08	Professional		$187.27	$260.36	$290.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.60 / $105.75 / $121.82	Professional	26	$89.60	$105.75	$121.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.67 / $134.37 / $184.34	Professional	TC	$97.67	$134.37	$184.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $216.40 / $593.63 / $860.76	Professional		$216.40	$593.63	$860.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.98 / $161.47 / $231.53	Professional	26	$109.98	$161.47	$231.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.42 / $432.16 / $626.63	Professional	TC	$106.42	$432.16	$626.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $539.16 / $903.13 / $1,302.58	Professional		$539.16	$903.13	$1,302.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $135.99 / $229.46 / $335.93	Professional	26	$135.99	$229.46	$335.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $395.50 / $662.98 / $966.66	Professional	TC	$395.50	$662.98	$966.66
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $462.88 / $800.69 / $1,428.68	Professional		$462.88	$800.69	$1,428.68
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $125.90 / $223.75 / $414.73	Professional	26	$125.90	$223.75	$414.73
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $336.97 / $598.86 / $1,110.01	Professional	TC	$336.97	$598.86	$1,110.01
United Facility/Professional Professional Modifier Low / Median / High Price $462.88 / $622.88 / $1,124.32	Professional		$462.88	$622.88	$1,124.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.12 / $159.51 / $325.42	Professional	26	$110.12	$159.51	$325.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $353.98 / $490.77 / $1,006.90	Professional	TC	$353.98	$490.77	$1,006.90
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $182.25 / $250.78 / $602.88	Professional		$182.25	$250.78	$602.88
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $91.49 / $107.64 / $148.37	Professional	26	$91.49	$107.64	$148.37
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $90.09 / $108.11 / $504.46	Professional	TC	$90.09	$108.11	$504.46