Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	26	$67.61	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $269.15	Professional		$75.86	$109.65	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $45.71 / $165.96	Professional	26	$15.85	$45.71	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $58.88 / $199.53	Professional	TC	$44.67	$58.88	$199.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $151.36 / $239.88	Professional		$95.50	$151.36	$239.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $67.61 / $93.33	Professional	26	$44.67	$67.61	$93.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $79.43 / $125.89	Professional	TC	$51.29	$79.43	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $194.98 / $426.58	Professional		$123.03	$194.98	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $58.88 / $134.90	Professional	26	$28.84	$58.88	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $120.23 / $389.05	Professional	TC	$67.61	$120.23	$389.05
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $169.82 / $251.19	Professional		$104.71	$169.82	$251.19
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $79.43 / $117.49	Professional	26	$51.29	$79.43	$117.49
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $95.50 / $141.25	Professional	TC	$60.26	$95.50	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $169.82 / $489.78	Professional		$112.20	$169.82	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $60.26 / $107.15	Professional	26	$22.39	$60.26	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $93.33 / $288.40	Professional	TC	$61.66	$93.33	$288.40
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $33.88 / $33.88	Facility	26	$28.84	$33.88	$33.88