Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.06 / $84.38 / $214.77	Professional		$83.06	$84.38	$214.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.02 / $26.01 / $49.35	Professional	26	$25.02	$26.01	$49.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.04 / $58.37 / $165.42	Professional	TC	$58.04	$58.37	$165.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.96 / $180.95 / $242.05	Professional		$45.96	$180.95	$242.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.43 / $52.87 / $70.72	Professional	26	$13.43	$52.87	$70.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.53 / $128.08 / $171.33	Professional	TC	$32.53	$128.08	$171.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.22 / $114.39 / $413.62	Professional		$54.22	$114.39	$413.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.09 / $32.17 / $121.74	Professional	26	$16.09	$32.17	$121.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.59 / $82.22 / $318.58	Professional	TC	$38.59	$82.22	$318.58
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $121.09 / $175.58 / $373.74	Professional		$121.09	$175.58	$373.74
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $35.54 / $51.55 / $109.73	Professional	26	$35.54	$51.55	$109.73
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $85.54 / $124.03 / $264.02	Professional	TC	$85.54	$124.03	$264.02
United Facility/Professional Professional Modifier Low / Median / High Price $71.29 / $118.81 / $151.41	Professional		$71.29	$118.81	$151.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.66 / $36.10 / $63.21	Professional	26	$21.66	$36.10	$63.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.68 / $94.48 / $356.55	Professional	TC	$56.68	$94.48	$356.55
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $94.15 / $126.81 / $259.74	Professional		$94.15	$126.81	$259.74
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $26.86 / $37.60 / $67.83	Professional	26	$26.86	$37.60	$67.83
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $63.72 / $79.01 / $176.62	Professional	TC	$63.72	$79.01	$176.62