Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.33 / $219.94 / $219.94	Facility	26	$92.33	$219.94	$219.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.35 / $440.38 / $458.21	Professional		$174.35	$440.38	$458.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.83 / $52.95 / $55.69	Professional	26	$45.83	$52.95	$55.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.52 / $387.44 / $402.52	Professional	TC	$128.52	$387.44	$402.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.55 / $310.58 / $450.34	Professional		$211.55	$310.58	$450.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.19 / $86.91 / $126.01	Professional	26	$59.19	$86.91	$126.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $152.35 / $223.68 / $324.33	Professional	TC	$152.35	$223.68	$324.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.43 / $506.37 / $926.57	Professional		$298.43	$506.37	$926.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.44 / $125.66 / $182.06	Professional	26	$77.44	$125.66	$182.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.53 / $371.84 / $677.69	Professional	TC	$216.53	$371.84	$677.69
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $242.28 / $430.40 / $797.77	Professional		$242.28	$430.40	$797.77
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $67.79 / $121.74 / $223.21	Professional	26	$67.79	$121.74	$223.21
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $174.48 / $313.30 / $574.52	Professional	TC	$174.48	$313.30	$574.52
United Facility/Professional Professional Modifier Low / Median / High Price $294.02 / $318.52 / $758.39	Professional		$294.02	$318.52	$758.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $85.86 / $241.08	Professional	26	$58.77	$85.86	$241.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $214.77 / $222.29 / $686.39	Professional	TC	$214.77	$222.29	$686.39
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $187.00 / $205.70 / $261.80	Professional		$187.00	$205.70	$261.80
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $48.73 / $53.99 / $58.90	Professional	26	$48.73	$53.99	$58.90
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $136.93 / $151.71 / $165.50	Professional	TC	$136.93	$151.71	$165.50