Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.60 / $131.60 / $131.60	Facility	26	$131.60	$131.60	$131.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.48 / $136.02 / $356.81	Professional		$111.48	$136.02	$356.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.18 / $46.06 / $120.06	Professional	26	$43.18	$46.06	$120.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.69 / $89.96 / $237.77	Professional	TC	$65.69	$89.96	$237.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.18 / $204.81 / $300.61	Professional		$140.18	$204.81	$300.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.43 / $54.47 / $79.61	Professional	26	$40.43	$54.47	$79.61
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $210.27 / $308.52 / $450.91	Professional	50	$210.27	$308.52	$450.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.30 / $150.21 / $220.98	Professional	TC	$89.30	$150.21	$220.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.97 / $238.36 / $404.21	Professional		$155.97	$238.36	$404.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.65 / $73.87 / $112.91	Professional	26	$42.65	$73.87	$112.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.41 / $164.61 / $302.87	Professional	TC	$106.41	$164.61	$302.87
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $174.78 / $309.95 / $575.74	Professional		$174.78	$309.95	$575.74
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $46.29 / $80.06 / $152.47	Professional	26	$46.29	$80.06	$152.47
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $128.49 / $222.26 / $423.26	Professional	TC	$128.49	$222.26	$423.26
United Facility/Professional Professional Modifier Low / Median / High Price $109.61 / $155.63 / $256.50	Professional		$109.61	$155.63	$256.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.03 / $60.27 / $97.49	Professional	26	$44.03	$60.27	$97.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.53 / $108.35 / $211.37	Professional	TC	$65.53	$108.35	$211.37
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $91.29 / $103.74 / $146.49	Professional		$91.29	$103.74	$146.49
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $33.47 / $40.15 / $53.88	Professional	26	$33.47	$40.15	$53.88
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $49.52 / $61.90 / $93.79	Professional	TC	$49.52	$61.90	$93.79