Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.25 / $83.24 / $83.24	Facility	26	$31.25	$83.24	$83.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.05 / $63.02 / $194.62	Professional		$50.05	$63.02	$194.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.71 / $19.57 / $57.87	Professional	26	$16.71	$19.57	$57.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.34 / $43.78 / $136.72	Professional	TC	$33.34	$43.78	$136.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.40 / $93.08 / $131.83	Professional		$63.40	$93.08	$131.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $29.44 / $41.63	Professional	26	$20.05	$29.44	$41.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.34 / $63.64 / $89.99	Professional	TC	$43.34	$63.64	$89.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.42 / $133.16 / $200.93	Professional		$84.42	$133.16	$200.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.21 / $42.01 / $62.03	Professional	26	$26.21	$42.01	$62.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.21 / $88.52 / $138.27	Professional	TC	$58.21	$88.52	$138.27
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $72.58 / $125.55 / $239.09	Professional		$72.58	$125.55	$239.09
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $22.96 / $36.08 / $75.63	Professional	26	$22.96	$36.08	$75.63
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $49.62 / $88.18 / $163.44	Professional	TC	$49.62	$88.18	$163.44
United Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $86.07 / $214.32	Professional		$72.31	$86.07	$214.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.28 / $28.54 / $57.97	Professional	26	$22.28	$28.54	$57.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.25 / $53.95 / $108.43	Professional	TC	$43.25	$53.95	$108.43
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $50.38 / $60.46 / $88.87	Professional		$50.38	$60.46	$88.87
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $16.97 / $20.35 / $27.51	Professional	26	$16.97	$20.35	$27.51
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $33.29 / $39.61 / $56.23	Professional	TC	$33.29	$39.61	$56.23