Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.67 / $120.26 / $120.26	Facility	26	$48.67	$120.26	$120.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.20 / $79.14 / $113.48	Professional		$76.20	$79.14	$113.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.14 / $29.80 / $41.12	Professional	26	$27.14	$29.80	$41.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.06 / $49.35 / $72.36	Professional	TC	$49.06	$49.35	$72.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.13 / $105.90 / $148.47	Professional		$72.13	$105.90	$148.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.05 / $45.59 / $63.92	Professional	26	$31.05	$45.59	$63.92
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $108.19 / $158.85 / $222.72	Professional	50	$108.19	$158.85	$222.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.08 / $60.31 / $84.56	Professional	TC	$41.08	$60.31	$84.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.99 / $149.82 / $230.66	Professional		$95.99	$149.82	$230.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.21 / $61.67 / $96.56	Professional	26	$39.21	$61.67	$96.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.44 / $89.90 / $134.10	Professional	TC	$56.44	$89.90	$134.10
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $81.15 / $137.50 / $272.02	Professional		$81.15	$137.50	$272.02
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $35.54 / $63.18 / $117.11	Professional	26	$35.54	$63.18	$117.11
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $47.03 / $83.58 / $154.91	Professional	TC	$47.03	$83.58	$154.91
United Facility/Professional Professional Modifier Low / Median / High Price $104.63 / $129.94 / $189.64	Professional		$104.63	$129.94	$189.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.75 / $46.38 / $151.54	Professional	26	$34.75	$46.38	$151.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.59 / $80.75 / $153.12	Professional	TC	$64.59	$80.75	$153.12
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $79.69 / $95.68 / $140.63	Professional		$79.69	$95.68	$140.63
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $27.44 / $32.93 / $44.91	Professional	26	$27.44	$32.93	$44.91
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $49.37 / $60.55 / $83.45	Professional	TC	$49.37	$60.55	$83.45