Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $173.78	Facility	26	$128.82	$128.82	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $295.12 / $537.03	Professional		$199.53	$295.12	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $109.65 / $204.17	Professional	26	$66.07	$109.65	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $194.98 / $363.08	Professional	TC	$131.83	$194.98	$363.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $512.86 / $741.31	Professional		$218.78	$512.86	$741.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $169.82 / $245.47	Professional	26	$72.44	$169.82	$245.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $331.13 / $512.86	Professional	TC	$144.54	$331.13	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $512.86 / $758.58	Professional		$295.12	$512.86	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $151.36 / $229.09	Professional	26	$95.50	$151.36	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $323.59 / $524.81	Professional	TC	$199.53	$323.59	$524.81
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $398.11 / $616.60	Professional		$251.19	$398.11	$616.60
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $131.83 / $199.53	Professional	26	$85.11	$131.83	$199.53
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $263.03 / $407.38	Professional	TC	$169.82	$263.03	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $416.87 / $1,202.26	Professional		$257.04	$416.87	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $104.71 / $218.78	Professional	26	$74.13	$104.71	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $269.15 / $1,047.13	Professional	TC	$173.78	$269.15	$1,047.13
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $56.23 / $56.23	Facility	26	$47.86	$56.23	$56.23