Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.52 / $143.18 / $143.18	Facility	26	$46.52	$143.18	$143.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.00 / $131.13 / $145.34	Professional		$124.00	$131.13	$145.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.03 / $46.10 / $55.79	Professional	26	$33.03	$46.10	$55.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.97 / $91.72 / $99.04	Professional	TC	$90.97	$91.72	$99.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.09 / $290.50 / $421.22	Professional		$73.09	$290.50	$421.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.44 / $68.67 / $99.57	Professional	26	$17.44	$68.67	$99.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.86 / $221.83 / $321.64	Professional	TC	$54.86	$221.83	$321.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.74 / $168.13 / $500.08	Professional		$86.74	$168.13	$500.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.82 / $41.15 / $114.42	Professional	26	$20.82	$41.15	$114.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.84 / $110.77 / $385.65	Professional	TC	$62.84	$110.77	$385.65
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $201.94 / $368.28 / $651.00	Professional		$201.94	$368.28	$651.00
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $47.85 / $82.48 / $151.27	Professional	26	$47.85	$82.48	$151.27
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $153.58 / $264.74 / $485.48	Professional	TC	$153.58	$264.74	$485.48
United Facility/Professional Professional Modifier Low / Median / High Price $107.11 / $181.90 / $190.37	Professional		$107.11	$181.90	$190.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $46.38 / $68.88	Professional	26	$24.78	$46.38	$68.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.39 / $143.99 / $143.99	Professional	TC	$86.39	$143.99	$143.99
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $145.47 / $169.92 / $256.63	Professional		$145.47	$169.92	$256.63
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $34.56 / $47.51 / $65.45	Professional	26	$34.56	$47.51	$65.45
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $99.61 / $127.56 / $179.83	Professional	TC	$99.61	$127.56	$179.83