Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.05 / $186.51 / $186.51	Facility	26	$68.05	$186.51	$186.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.61 / $228.16 / $256.02	Professional		$189.61	$228.16	$256.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.46 / $42.77 / $48.48	Professional	26	$35.46	$42.77	$48.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.15 / $185.40 / $207.54	Professional	TC	$154.15	$185.40	$207.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.22 / $293.95 / $426.24	Professional		$200.22	$293.95	$426.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.67 / $64.11 / $92.95	Professional	26	$43.67	$64.11	$92.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $156.56 / $229.85 / $333.28	Professional	TC	$156.56	$229.85	$333.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.27 / $495.70 / $681.97	Professional		$267.27	$495.70	$681.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.07 / $102.73 / $135.03	Professional	26	$57.07	$102.73	$135.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.22 / $392.97 / $553.38	Professional	TC	$210.22	$392.97	$553.38
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $233.14 / $407.37 / $935.58	Professional		$233.14	$407.37	$935.58
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $50.74 / $88.65 / $164.67	Professional	26	$50.74	$88.65	$164.67
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $181.94 / $317.85 / $590.40	Professional	TC	$181.94	$317.85	$590.40
United Facility/Professional Professional Modifier Low / Median / High Price $291.79 / $352.58 / $771.75	Professional		$291.79	$352.58	$771.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.31 / $59.92 / $91.01	Professional	26	$46.31	$59.92	$91.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.04 / $250.26 / $339.90	Professional	TC	$204.04	$250.26	$339.90
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $185.92 / $223.10 / $327.96	Professional		$185.92	$223.10	$327.96
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $37.08 / $44.50 / $59.70	Professional	26	$37.08	$44.50	$59.70
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $148.84 / $177.12 / $258.23	Professional	TC	$148.84	$177.12	$258.23