Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.83 / $173.60 / $219.14	Professional		$162.83	$173.60	$219.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.98 / $33.14 / $312.00	Professional	26	$31.98	$33.14	$312.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.68 / $136.61 / $187.16	Professional	TC	$129.68	$136.61	$187.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.75 / $550.48 / $736.37	Professional		$132.75	$550.48	$736.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.30 / $68.67 / $91.85	Professional	26	$17.30	$68.67	$91.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $115.45 / $481.81 / $644.51	Professional	TC	$115.45	$481.81	$644.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.05 / $272.10 / $813.12	Professional		$136.05	$272.10	$813.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.45 / $41.00 / $112.38	Professional	26	$20.45	$41.00	$112.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $116.35 / $232.70 / $700.74	Professional	TC	$116.35	$232.70	$700.74
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $302.54 / $438.68 / $933.79	Professional		$302.54	$438.68	$933.79
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $44.81 / $64.97 / $138.31	Professional	26	$44.81	$64.97	$138.31
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $257.73 / $373.71 / $795.48	Professional	TC	$257.73	$373.71	$795.48
United Facility/Professional Professional Modifier Low / Median / High Price $216.86 / $348.26 / $632.88	Professional		$216.86	$348.26	$632.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.02 / $46.70 / $81.77	Professional	26	$28.02	$46.70	$81.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.84 / $314.74 / $551.11	Professional	TC	$188.84	$314.74	$551.11
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $179.52 / $323.91 / $525.24	Professional		$179.52	$323.91	$525.24
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $34.52 / $41.37 / $58.38	Professional	26	$34.52	$41.37	$58.38
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $142.08 / $278.93 / $407.09	Professional	TC	$142.08	$278.93	$407.09