Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.33 / $76.27 / $76.27	Facility	26	$29.33	$76.27	$76.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.11 / $42.82 / $108.85	Professional		$37.11	$42.82	$108.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.46 / $22.88 / $59.35	Professional	26	$20.46	$22.88	$59.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.67 / $19.05 / $59.60	Professional	TC	$16.67	$19.05	$59.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $110.19 / $187.90	Professional		$53.70	$110.19	$187.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.41 / $39.83 / $67.56	Professional	26	$19.41	$39.83	$67.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.29 / $70.36 / $114.08	Professional	TC	$34.29	$70.36	$114.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.18 / $85.26 / $154.68	Professional		$58.18	$85.26	$154.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.32 / $36.64 / $54.36	Professional	26	$26.32	$36.64	$54.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.55 / $53.07 / $100.32	Professional	TC	$26.55	$53.07	$100.32
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $53.02 / $96.59 / $189.73	Professional		$53.02	$96.59	$189.73
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $21.84 / $33.70 / $68.58	Professional	26	$21.84	$33.70	$68.58
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $39.25 / $61.67 / $121.15	Professional	TC	$39.25	$61.67	$121.15
United Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $72.20 / $168.96	Professional		$50.72	$72.20	$168.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.89 / $33.93 / $62.04	Professional	26	$21.89	$33.93	$62.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.10 / $45.07 / $92.82	Professional	TC	$27.10	$45.07	$92.82
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $30.85 / $45.01 / $69.04	Professional		$30.85	$45.01	$69.04
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $16.29 / $20.36 / $28.82	Professional	26	$16.29	$20.36	$28.82
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $17.10 / $26.28 / $36.79	Professional	TC	$17.10	$26.28	$36.79