Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.75 / $62.12 / $88.98	Professional		$57.75	$62.12	$88.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $20.50 / $24.70	Professional	26	$18.30	$20.50	$24.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.45 / $41.62 / $64.28	Professional	TC	$39.45	$41.62	$64.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.64 / $184.76 / $247.15	Professional		$44.64	$184.76	$247.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.87 / $50.68 / $67.79	Professional	26	$12.87	$50.68	$67.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.10 / $134.07 / $179.34	Professional	TC	$31.10	$134.07	$179.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.89 / $114.08 / $361.72	Professional		$53.89	$114.08	$361.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $32.29 / $89.45	Professional	26	$16.14	$32.29	$89.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.43 / $82.41 / $272.27	Professional	TC	$37.43	$82.41	$272.27
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $145.16 / $210.48 / $448.04	Professional		$145.16	$210.48	$448.04
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $36.65 / $53.16 / $113.15	Professional	26	$36.65	$53.16	$113.15
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $108.50 / $147.26 / $334.89	Professional	TC	$108.50	$147.26	$334.89
United Facility/Professional Professional Modifier Low / Median / High Price $72.22 / $120.36 / $210.75	Professional		$72.22	$120.36	$210.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.57 / $34.27 / $42.60	Professional	26	$20.57	$34.27	$42.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.65 / $86.09 / $150.74	Professional	TC	$51.65	$86.09	$150.74
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $63.92 / $107.23 / $173.89	Professional		$63.92	$107.23	$173.89
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $20.70 / $29.30 / $41.02	Professional	26	$20.70	$29.30	$41.02
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $43.22 / $76.28 / $106.79	Professional	TC	$43.22	$76.28	$106.79