Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.52 / $122.52 / $122.52	Facility		$122.52	$122.52	$122.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.59 / $32.59 / $32.59	Facility	26	$32.59	$32.59	$32.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.60 / $29.09 / $80.64	Professional		$18.60	$29.09	$80.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.96 / $4.09 / $10.86	Professional	26	$2.96	$4.09	$10.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.30 / $13.20 / $15.33	Professional	52	$9.30	$13.20	$15.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.16 / $24.99 / $69.77	Professional	TC	$18.16	$24.99	$69.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.32 / $30.06 / $44.24	Professional		$22.32	$30.06	$44.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.91 / $3.91 / $5.73	Professional	26	$2.91	$3.91	$5.73
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $33.47 / $45.10 / $65.91	Professional	50	$33.47	$45.10	$65.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.41 / $26.14 / $38.20	Professional	TC	$19.41	$26.14	$38.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.90 / $43.96 / $76.22	Professional		$23.90	$43.96	$76.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.03 / $5.64 / $16.38	Professional	26	$3.03	$5.64	$16.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.86 / $38.38 / $65.70	Professional	TC	$20.86	$38.38	$65.70
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $26.69 / $52.19 / $90.90	Professional		$26.69	$52.19	$90.90
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $3.33 / $5.76 / $10.97	Professional	26	$3.33	$5.76	$10.97
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $22.22 / $39.49 / $73.19	Professional	TC	$22.22	$39.49	$73.19
United Facility/Professional Professional Modifier Low / Median / High Price $26.68 / $40.40 / $72.23	Professional		$26.68	$40.40	$72.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.25 / $5.08 / $15.43	Professional	26	$3.25	$5.08	$15.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.13 / $28.87 / $47.27	Professional	TC	$19.13	$28.87	$47.27
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $19.54 / $32.36 / $48.54	Professional		$19.54	$32.36	$48.54
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $2.68 / $4.30 / $12.50	Professional	26	$2.68	$4.30	$12.50
Well Sense Facility/Professional Professional Modifier 52 Low / Median / High Price $9.69 / $11.63 / $13.08	Professional	52	$9.69	$11.63	$13.08
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $15.32 / $21.08 / $32.44	Professional	TC	$15.32	$21.08	$32.44