Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.79 / $324.75 / $447.11	Professional		$302.79	$324.75	$447.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.95 / $37.85 / $37.99	Professional	26	$35.95	$37.85	$37.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $266.83 / $286.89 / $409.12	Professional	TC	$266.83	$286.89	$409.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.60 / $713.44 / $1,008.94	Professional		$177.60	$713.44	$1,008.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.23 / $75.76 / $101.34	Professional	26	$19.23	$75.76	$101.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.36 / $637.67 / $901.80	Professional	TC	$158.36	$637.67	$901.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.72 / $405.43 / $1,186.26	Professional		$202.72	$405.43	$1,186.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.48 / $46.09 / $129.06	Professional	26	$23.48	$46.09	$129.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.73 / $359.46 / $1,057.20	Professional	TC	$179.73	$359.46	$1,057.20
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $450.28 / $652.91 / $1,389.79	Professional		$450.28	$652.91	$1,389.79
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $52.21 / $75.70 / $161.15	Professional	26	$52.21	$75.70	$161.15
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $398.07 / $577.20 / $1,228.64	Professional	TC	$398.07	$577.20	$1,228.64
United Facility/Professional Professional Modifier Low / Median / High Price $318.45 / $469.24 / $819.01	Professional		$318.45	$469.24	$819.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.88 / $51.47 / $55.02	Professional	26	$30.88	$51.47	$55.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $249.76 / $399.51 / $728.89	Professional	TC	$249.76	$399.51	$728.89
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $395.03 / $502.77 / $3,375.00	Professional		$395.03	$502.77	$3,375.00
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $38.32 / $45.60 / $67.59	Professional	26	$38.32	$45.60	$67.59
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $320.80 / $381.75 / $607.60	Professional	TC	$320.80	$381.75	$607.60