Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $331.13	Professional		$87.10	$117.49	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $72.44 / $186.21	Professional	26	$56.23	$72.44	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $44.67 / $109.65	Professional	TC	$28.18	$44.67	$109.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $257.04 / $380.19	Professional		$104.71	$257.04	$380.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $141.25 / $213.80	Professional	26	$58.88	$141.25	$213.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $107.15 / $162.18	Professional	TC	$44.67	$107.15	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $177.83 / $309.03	Professional		$123.03	$177.83	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $107.15 / $173.78	Professional	26	$75.86	$107.15	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $67.61 / $134.90	Professional	TC	$41.69	$67.61	$134.90
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $158.49 / $275.42	Professional		$104.71	$158.49	$275.42
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $97.72 / $165.96	Professional	26	$64.57	$97.72	$165.96
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $74.13 / $125.89	Professional	TC	$48.98	$74.13	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $158.49 / $295.12	Professional		$100.00	$158.49	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $102.33 / $181.97	Professional	26	$63.10	$102.33	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $57.54 / $117.49	Professional	TC	$36.31	$57.54	$117.49
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $44.67 / $75.86	Facility	26	$38.02	$44.67	$75.86