Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.33 / $36.75 / $76.81	Facility	26	$22.33	$36.75	$76.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.95 / $82.35 / $99.30	Professional		$76.95	$82.35	$99.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $22.34 / $36.85	Professional	26	$20.05	$22.34	$36.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.91 / $60.00 / $73.88	Professional	TC	$56.91	$60.00	$73.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $225.65 / $327.19	Professional		$54.00	$225.65	$327.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.70 / $54.51 / $79.03	Professional	26	$13.70	$54.51	$79.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.31 / $171.14 / $248.15	Professional	TC	$39.31	$171.14	$248.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.12 / $127.31 / $375.91	Professional		$64.12	$127.31	$375.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.98 / $31.96 / $90.39	Professional	26	$15.98	$31.96	$90.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.45 / $94.72 / $285.52	Professional	TC	$46.45	$94.72	$285.52
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $149.34 / $254.69 / $472.08	Professional		$149.34	$254.69	$472.08
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $36.84 / $63.74 / $119.54	Professional	26	$36.84	$63.74	$119.54
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $111.53 / $192.23 / $352.53	Professional	TC	$111.53	$192.23	$352.53
United Facility/Professional Professional Modifier Low / Median / High Price $87.11 / $140.38 / $173.02	Professional		$87.11	$140.38	$173.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.91 / $36.52 / $102.84	Professional	26	$21.91	$36.52	$102.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.20 / $92.84 / $108.66	Professional	TC	$65.20	$92.84	$108.66
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $84.97 / $121.83 / $200.65	Professional		$84.97	$121.83	$200.65
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $22.61 / $31.43 / $44.00	Professional	26	$22.61	$31.43	$44.00
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $62.35 / $90.41 / $126.57	Professional	TC	$62.35	$90.41	$126.57