Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $149.09 / $364.92 / $364.92	Facility	26	$149.09	$364.92	$364.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $613.07 / $946.50 / $946.50	Professional		$613.07	$946.50	$946.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $534.46 / $840.02 / $840.02	Professional	TC	$534.46	$840.02	$840.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $912.17 / $1,295.51 / $1,878.48	Professional		$912.17	$1,295.51	$1,878.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $815.78 / $1,158.60 / $1,679.98	Professional	TC	$815.78	$1,158.60	$1,679.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,197.49 / $2,002.49 / $3,330.22	Professional		$1,197.49	$2,002.49	$3,330.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,083.25 / $1,802.02 / $3,021.91	Professional	TC	$1,083.25	$1,802.02	$3,021.91
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $1,044.67 / $1,989.51 / $3,439.86	Professional		$1,044.67	$1,989.51	$3,439.86
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $934.27 / $1,677.61 / $3,076.36	Professional	TC	$934.27	$1,677.61	$3,076.36
United Facility/Professional Professional Modifier Low / Median / High Price $443.46 / $1,168.69 / $4,089.88	Professional		$443.46	$1,168.69	$4,089.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $403.88 / $1,319.68 / $3,602.55	Professional	TC	$403.88	$1,319.68	$3,602.55
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $689.46 / $758.41 / $965.24	Professional		$689.46	$758.41	$965.24
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $605.78 / $671.19 / $732.20	Professional	TC	$605.78	$671.19	$732.20