Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.10 / $144.10 / $144.10	Facility	26	$144.10	$144.10	$144.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $787.50 / $971.95 / $1,005.00	Professional		$787.50	$971.95	$1,005.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.68 / $103.46 / $106.15	Professional	26	$78.68	$103.46	$106.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $708.82 / $868.49 / $900.01	Professional	TC	$708.82	$868.49	$900.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $777.29 / $1,660.71 / $2,408.02	Professional		$777.29	$1,660.71	$2,408.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $92.51 / $197.65 / $286.58	Professional	26	$92.51	$197.65	$286.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $684.78 / $1,463.06 / $2,121.42	Professional	TC	$684.78	$1,463.06	$2,121.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,040.65 / $1,970.81 / $2,584.10	Professional		$1,040.65	$1,970.81	$2,584.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.86 / $218.14 / $283.79	Professional	26	$120.86	$218.14	$283.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $919.79 / $1,752.67 / $2,310.12	Professional	TC	$919.79	$1,752.67	$2,310.12
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $905.05 / $1,581.41 / $3,640.64	Professional		$905.05	$1,581.41	$3,640.64
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $107.51 / $187.82 / $348.88	Professional	26	$107.51	$187.82	$348.88
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $795.77 / $1,390.22 / $2,582.34	Professional	TC	$795.77	$1,390.22	$2,582.34
United Facility/Professional Professional Modifier Low / Median / High Price $1,137.93 / $1,190.64 / $1,688.10	Professional		$1,137.93	$1,190.64	$1,688.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.68 / $131.22 / $191.27	Professional	26	$104.68	$131.22	$191.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $886.55 / $1,101.08 / $2,850.15	Professional	TC	$886.55	$1,101.08	$2,850.15
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $761.47 / $913.76 / $1,343.23	Professional		$761.47	$913.76	$1,343.23
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $77.88 / $91.62 / $138.37	Professional	26	$77.88	$91.62	$138.37
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $678.11 / $797.78 / $1,204.85	Professional	TC	$678.11	$797.78	$1,204.85