Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.32 / $106.32 / $106.32	Facility	26	$41.32	$106.32	$106.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.77 / $95.79 / $110.16	Professional		$71.77	$95.79	$110.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.56 / $69.26 / $77.54	Professional	TC	$47.56	$69.26	$77.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.39 / $125.37 / $177.29	Professional		$85.39	$125.37	$177.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.87 / $86.43 / $122.22	Professional	TC	$58.87	$86.43	$122.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.67 / $180.13 / $294.14	Professional		$113.67	$180.13	$294.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.41 / $128.49 / $224.88	Professional	TC	$77.41	$128.49	$224.88
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $97.76 / $173.74 / $322.02	Professional		$97.76	$173.74	$322.02
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $67.39 / $119.51 / $221.99	Professional	TC	$67.39	$119.51	$221.99
United Facility/Professional Professional Modifier Low / Median / High Price $100.93 / $133.13 / $449.41	Professional		$100.93	$133.13	$449.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.80 / $87.74 / $166.60	Professional	TC	$72.80	$87.74	$166.60
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $78.01 / $85.81 / $109.21	Professional		$78.01	$85.81	$109.21
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $53.76 / $59.57 / $64.98	Professional	TC	$53.76	$59.57	$64.98