Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	26	$52.48	$52.48	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $54.95 / $128.82	Professional		$42.66	$54.95	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.85 / $41.69	Professional	26	$12.88	$15.85	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $38.90 / $85.11	Professional	TC	$28.84	$38.90	$85.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $102.33 / $151.36	Professional		$39.81	$102.33	$151.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $32.36 / $50.12	Professional	26	$13.49	$32.36	$50.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $66.07 / $100.00	Professional	TC	$45.71	$66.07	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $87.10 / $134.90	Professional		$54.95	$87.10	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $25.70 / $40.74	Professional	26	$17.38	$25.70	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $61.66 / $93.33	Professional	TC	$37.15	$61.66	$93.33
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $64.57 / $112.20	Professional		$34.67	$64.57	$112.20
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $21.88 / $37.15	Professional	26	$14.79	$21.88	$37.15
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $43.65 / $75.86	Professional	TC	$29.51	$43.65	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $83.18 / $141.25	Professional		$47.86	$83.18	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $24.55 / $44.67	Professional	26	$14.79	$24.55	$44.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $57.54 / $100.00	Professional	TC	$33.11	$57.54	$100.00
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $14.45 / $17.78	Facility	26	$10.47	$14.45	$17.78