Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $707.95	Professional		$162.18	$218.78	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $95.50 / $501.19	Professional	26	$33.11	$95.50	$501.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $186.21 / $602.56	Professional	TC	$128.82	$186.21	$602.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $549.54 / $741.31	Professional		$141.25	$549.54	$741.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $69.18 / $91.20	Professional	26	$18.62	$69.18	$91.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $478.63 / $645.65	Professional	TC	$123.03	$478.63	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $281.84 / $812.83	Professional		$134.90	$281.84	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $43.65 / $112.20	Professional	26	$20.89	$43.65	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $239.88 / $707.95	Professional	TC	$117.49	$239.88	$707.95
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $436.52 / $831.76	Professional		$309.03	$436.52	$831.76
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $60.26 / $123.03	Professional	26	$45.71	$60.26	$123.03
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $346.74 / $707.95	Professional	TC	$263.03	$346.74	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $363.08 / $891.25	Professional		$275.42	$363.08	$891.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $51.29 / $114.82	Professional	26	$39.81	$51.29	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $316.23 / $758.58	Professional	TC	$234.42	$316.23	$758.58