Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.79 / $72.79 / $100.29	Facility	26	$72.79	$72.79	$100.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.97 / $463.49 / $515.87	Professional		$416.97	$463.49	$515.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.38 / $64.28 / $72.79	Professional	26	$55.38	$64.28	$72.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $361.60 / $399.20 / $443.08	Professional	TC	$361.60	$399.20	$443.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $412.42 / $881.15 / $1,277.66	Professional		$412.42	$881.15	$1,277.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.37 / $137.53 / $199.41	Professional	26	$64.37	$137.53	$199.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $348.05 / $743.62 / $1,078.24	Professional	TC	$348.05	$743.62	$1,078.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $551.66 / $1,040.26 / $1,371.30	Professional		$551.66	$1,040.26	$1,371.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.11 / $151.53 / $197.85	Professional	26	$84.11	$151.53	$197.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $467.56 / $888.73 / $1,178.50	Professional	TC	$467.56	$888.73	$1,178.50
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $480.20 / $839.07 / $3,253.80	Professional		$480.20	$839.07	$3,253.80
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $74.80 / $130.68 / $242.74	Professional	26	$74.80	$130.68	$242.74
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $404.46 / $706.59 / $1,312.50	Professional	TC	$404.46	$706.59	$1,312.50
United Facility/Professional Professional Modifier Low / Median / High Price $507.17 / $631.94 / $892.70	Professional		$507.17	$631.94	$892.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.70 / $92.32 / $225.88	Professional	26	$73.70	$92.32	$225.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $527.05 / $655.82 / $1,457.08	Professional	TC	$527.05	$655.82	$1,457.08
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $403.64 / $484.37 / $712.02	Professional		$403.64	$484.37	$712.02
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $54.80 / $64.47 / $97.37	Professional	26	$54.80	$64.47	$97.37
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $345.94 / $406.99 / $614.66	Professional	TC	$345.94	$406.99	$614.66