Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $281.84 / $602.56	Facility	26	$199.53	$281.84	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,000.00 / $2,754.23	Professional		$724.44	$1,000.00	$2,754.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $199.53 / $549.54	Professional	26	$107.15	$199.53	$549.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $154.88 / $1,071.52 / $1,479.11	Professional	52	$154.88	$1,071.52	$1,479.11
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $549.54 / $549.54 / $549.54	Professional	53	$549.54	$549.54	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $758.58 / $1,737.80	Professional	TC	$588.84	$758.58	$1,737.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,230.27 / $1,698.24	Professional		$794.33	$1,230.27	$1,698.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $190.55 / $263.03	Professional	26	$117.49	$190.55	$263.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $691.83 / $1,023.29 / $1,445.44	Professional	TC	$691.83	$1,023.29	$1,445.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,380.38 / $2,290.87	Professional		$794.33	$1,380.38	$2,290.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $251.19 / $446.68	Professional	26	$123.03	$251.19	$446.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $676.08 / $1,174.90 / $1,949.84	Professional	TC	$676.08	$1,174.90	$1,949.84
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,445.44 / $2,238.72	Professional		$933.25	$1,445.44	$2,238.72
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $213.80 / $316.23	Professional	26	$134.90	$213.80	$316.23
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $794.33 / $1,230.27 / $1,819.70	Professional	TC	$794.33	$1,230.27	$1,819.70
United Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,445.44 / $2,691.53	Professional		$891.25	$1,445.44	$2,691.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $223.87 / $416.87	Professional	26	$131.83	$223.87	$416.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $1,230.27 / $2,290.87	Professional	TC	$758.58	$1,230.27	$2,290.87
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $83.18 / $83.18	Facility	26	$70.79	$83.18	$83.18