Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $93.33 / $93.33	Facility	26	$93.33	$93.33	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $61.66 / $173.78	Professional		$43.65	$61.66	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.18 / $79.43	Professional	26	$22.91	$28.18	$79.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $33.11 / $66.07	Professional	TC	$15.85	$33.11	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $144.54 / $213.80	Professional		$58.88	$144.54	$213.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $58.88 / $89.13	Professional	26	$25.12	$58.88	$89.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $81.28 / $123.03	Professional	TC	$34.67	$81.28	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $100.00 / $177.83	Professional		$64.57	$100.00	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $44.67 / $72.44	Professional	26	$31.62	$44.67	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $50.12 / $104.71	Professional	TC	$25.70	$50.12	$104.71
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $95.50 / $165.96	Professional		$63.10	$95.50	$165.96
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $40.74 / $70.79	Professional	26	$27.54	$40.74	$70.79
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $48.98 / $91.20	Professional	TC	$38.02	$48.98	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $85.11 / $158.49	Professional		$52.48	$85.11	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $42.66 / $75.86	Professional	26	$26.30	$42.66	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $43.65 / $89.13	Professional	TC	$24.55	$43.65	$89.13
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $18.62 / $31.62	Facility	26	$15.85	$18.62	$31.62