Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $233.17 / $233.17 / $233.17	Facility	26	$233.17	$233.17	$233.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $274.10 / $317.47 / $358.77	Professional		$274.10	$317.47	$358.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.03 / $131.81 / $149.27	Professional	26	$110.03	$131.81	$149.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $164.07 / $185.65 / $209.50	Professional	TC	$164.07	$185.65	$209.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $450.26 / $639.48 / $927.24	Professional		$450.26	$639.48	$927.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $149.12 / $211.78 / $307.08	Professional	26	$149.12	$211.78	$307.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $301.14 / $427.70 / $620.16	Professional	TC	$301.14	$427.70	$620.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $579.83 / $942.03 / $1,405.02	Professional		$579.83	$942.03	$1,405.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $195.55 / $312.87 / $453.58	Professional	26	$195.55	$312.87	$453.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $399.25 / $634.79 / $951.44	Professional	TC	$399.25	$634.79	$951.44
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $515.66 / $982.05 / $1,697.98	Professional		$515.66	$982.05	$1,697.98
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $170.78 / $306.66 / $562.34	Professional	26	$170.78	$306.66	$562.34
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $344.89 / $619.29 / $1,135.64	Professional	TC	$344.89	$619.29	$1,135.64
United Facility/Professional Professional Modifier Low / Median / High Price $424.15 / $562.67 / $1,957.62	Professional		$424.15	$562.67	$1,957.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $153.79 / $197.43 / $345.51	Professional	26	$153.79	$197.43	$345.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $261.76 / $337.00 / $634.19	Professional	TC	$261.76	$337.00	$634.19
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $303.94 / $379.92 / $577.46	Professional		$303.94	$379.92	$577.46
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $117.61 / $138.36 / $190.90	Professional	26	$117.61	$138.36	$190.90
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $179.77 / $240.24 / $336.31	Professional	TC	$179.77	$240.24	$336.31