Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.38 / $170.94 / $170.94	Facility	26	$76.38	$170.94	$170.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.94 / $107.61 / $109.93	Professional		$70.94	$107.61	$109.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.86 / $46.44 / $47.10	Professional	26	$35.86	$46.44	$47.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.08 / $55.01 / $61.17	Professional	TC	$35.08	$55.01	$61.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.51 / $131.38 / $190.51	Professional		$92.51	$131.38	$190.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.84 / $69.37 / $100.58	Professional	26	$48.84	$69.37	$100.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.67 / $62.02 / $89.92	Professional	TC	$43.67	$62.02	$89.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.71 / $202.65 / $287.26	Professional		$122.71	$202.65	$287.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.53 / $103.19 / $149.54	Professional	26	$60.53	$103.19	$149.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.64 / $99.46 / $155.41	Professional	TC	$58.64	$99.46	$155.41
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $105.91 / $201.78 / $376.82	Professional		$105.91	$201.78	$376.82
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $55.94 / $106.54 / $184.21	Professional	26	$55.94	$106.54	$184.21
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $50.01 / $89.81 / $164.67	Professional	TC	$50.01	$89.81	$164.67
United Facility/Professional Professional Modifier Low / Median / High Price $119.06 / $143.87 / $451.39	Professional		$119.06	$143.87	$451.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.32 / $65.80 / $113.55	Professional	26	$46.32	$65.80	$113.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.48 / $67.05 / $160.47	Professional	TC	$55.48	$67.05	$160.47
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $75.06 / $90.08 / $133.04	Professional		$75.06	$90.08	$133.04
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $39.19 / $46.10 / $62.74	Professional	26	$39.19	$46.10	$62.74
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $35.60 / $42.72 / $67.43	Professional	TC	$35.60	$42.72	$67.43