Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.22 / $105.22 / $105.22	Facility	26	$105.22	$105.22	$105.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.39 / $49.44 / $123.96	Professional		$33.39	$49.44	$123.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.92 / $28.65 / $35.79	Professional	26	$18.92	$28.65	$35.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.46 / $23.77 / $88.56	Professional	TC	$14.46	$23.77	$88.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.52 / $50.54 / $74.40	Professional		$37.52	$50.54	$74.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $27.45 / $40.11	Professional	26	$20.38	$27.45	$40.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $56.28 / $75.81 / $110.81	Professional	50	$56.28	$75.81	$110.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $23.09 / $33.99	Professional	TC	$17.14	$23.09	$33.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $74.11 / $173.55	Professional		$39.86	$74.11	$173.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.45 / $39.85 / $72.87	Professional	26	$21.45	$39.85	$72.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.42 / $34.27 / $128.10	Professional	TC	$18.42	$34.27	$128.10
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $27.95 / $67.48 / $141.47	Professional		$27.95	$67.48	$141.47
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $23.33 / $40.36 / $76.84	Professional	26	$23.33	$40.36	$76.84
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $19.63 / $34.89 / $64.66	Professional	TC	$19.63	$34.89	$64.66
United Facility/Professional Professional Modifier Low / Median / High Price $45.21 / $66.56 / $176.04	Professional		$45.21	$66.56	$176.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.33 / $32.29 / $55.13	Professional	26	$23.33	$32.29	$55.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $25.60 / $126.85	Professional	TC	$21.10	$25.60	$126.85
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $33.44 / $42.39 / $108.30	Professional		$33.44	$42.39	$108.30
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $24.12 / $38.82	Professional	26	$17.23	$24.12	$38.82
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $13.58 / $16.98 / $78.73	Professional	TC	$13.58	$16.98	$78.73