Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.41 / $76.80 / $76.80	Facility	26	$25.41	$76.80	$76.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.43 / $40.95 / $95.62	Professional		$35.43	$40.95	$95.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.89 / $21.35 / $36.03	Professional	26	$17.89	$21.35	$36.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.17 / $17.17 / $53.07	Professional	TC	$15.17	$17.17	$53.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.58 / $95.59 / $163.00	Professional		$46.58	$95.59	$163.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.82 / $34.52 / $58.86	Professional	26	$16.82	$34.52	$58.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.76 / $61.07 / $99.01	Professional	TC	$29.76	$61.07	$99.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.58 / $75.02 / $134.41	Professional		$54.58	$75.02	$134.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.80 / $33.54 / $51.80	Professional	26	$22.80	$33.54	$51.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.61 / $46.05 / $87.30	Professional	TC	$23.61	$46.05	$87.30
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $47.99 / $80.87 / $164.57	Professional		$47.99	$80.87	$164.57
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $18.93 / $28.51 / $54.06	Professional	26	$18.93	$28.51	$54.06
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $34.07 / $53.53 / $105.16	Professional	TC	$34.07	$53.53	$105.16
United Facility/Professional Professional Modifier Low / Median / High Price $45.28 / $65.66 / $126.09	Professional		$45.28	$65.66	$126.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.09 / $31.04 / $62.87	Professional	26	$20.09	$31.04	$62.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.75 / $37.60 / $84.94	Professional	TC	$23.75	$37.60	$84.94
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $23.30 / $40.13 / $60.61	Professional		$23.30	$40.13	$60.61
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $14.41 / $19.42 / $27.29	Professional	26	$14.41	$19.42	$27.29
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $15.64 / $22.94 / $35.19	Professional	TC	$15.64	$22.94	$35.19