Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.83 / $114.27 / $114.27	Facility	26	$43.83	$114.27	$114.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.15 / $159.55 / $179.04	Professional		$149.15	$159.55	$179.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.09 / $26.76 / $30.36	Professional	26	$23.09	$26.76	$30.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $196.67 / $288.74 / $418.67	Professional		$196.67	$288.74	$418.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $41.32 / $59.91	Professional	26	$28.14	$41.32	$59.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.13 / $474.35 / $634.94	Professional		$263.13	$474.35	$634.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.77 / $66.88 / $85.97	Professional	26	$36.77	$66.88	$85.97
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $228.99 / $400.12 / $935.58	Professional		$228.99	$400.12	$935.58
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $32.71 / $57.14 / $106.14	Professional	26	$32.71	$57.14	$106.14
United Facility/Professional Professional Modifier Low / Median / High Price $155.21 / $294.76 / $1,211.83	Professional		$155.21	$294.76	$1,211.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.60 / $38.51 / $57.88	Professional	26	$28.60	$38.51	$57.88
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $161.06 / $216.59 / $332.23	Professional		$161.06	$216.59	$332.23
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $23.68 / $28.38 / $38.39	Professional	26	$23.68	$28.38	$38.39