Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.31 / $101.31 / $156.91	Facility	26	$101.31	$101.31	$156.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.31 / $293.74 / $331.59	Professional		$255.31	$293.74	$331.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.84 / $89.57 / $101.31	Professional	26	$74.84	$89.57	$101.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $180.46 / $204.15 / $230.28	Professional	TC	$180.46	$204.15	$230.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $339.31 / $481.91 / $698.76	Professional		$339.31	$481.91	$698.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.27 / $142.41 / $206.49	Professional	26	$100.27	$142.41	$206.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $239.04 / $339.50 / $492.27	Professional	TC	$239.04	$339.50	$492.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $452.63 / $765.01 / $1,066.59	Professional		$452.63	$765.01	$1,066.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.60 / $220.42 / $306.10	Professional	26	$131.60	$220.42	$306.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $321.02 / $554.47 / $760.49	Professional	TC	$321.02	$554.47	$760.49
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $388.60 / $740.06 / $1,382.03	Professional		$388.60	$740.06	$1,382.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $114.84 / $204.00 / $378.13	Professional	26	$114.84	$204.00	$378.13
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $273.76 / $491.57 / $901.43	Professional	TC	$273.76	$491.57	$901.43
United Facility/Professional Professional Modifier Low / Median / High Price $340.96 / $429.17 / $1,612.31	Professional		$340.96	$429.17	$1,612.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.44 / $133.44 / $235.84	Professional	26	$104.44	$133.44	$235.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $273.64 / $296.35 / $524.73	Professional	TC	$273.64	$296.35	$524.73
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $258.94 / $315.66 / $476.74	Professional		$258.94	$315.66	$476.74
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $79.48 / $93.51 / $128.88	Professional	26	$79.48	$93.51	$128.88
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $177.68 / $222.11 / $306.20	Professional	TC	$177.68	$222.11	$306.20