Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.90 / $216.38 / $216.38	Facility	26	$87.90	$216.38	$216.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.53 / $243.21 / $660.75	Professional		$215.53	$243.21	$660.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.55 / $67.41 / $188.93	Professional	26	$60.55	$67.41	$188.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.06 / $182.65 / $424.67	Professional	TC	$152.06	$182.65	$424.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.63 / $453.29 / $777.29	Professional		$208.63	$453.29	$777.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.22 / $122.46 / $211.21	Professional	26	$58.22	$122.46	$211.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $150.41 / $316.38 / $545.66	Professional	TC	$150.41	$316.38	$545.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.88 / $419.87 / $650.41	Professional		$271.88	$419.87	$650.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.38 / $115.97 / $174.16	Professional	26	$75.38	$115.97	$174.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.91 / $303.89 / $493.94	Professional	TC	$198.91	$303.89	$493.94
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $249.52 / $455.04 / $786.76	Professional		$249.52	$455.04	$786.76
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $66.65 / $115.29 / $205.72	Professional	26	$66.65	$115.29	$205.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $172.19 / $297.85 / $531.46	Professional	TC	$172.19	$297.85	$531.46
United Facility/Professional Professional Modifier Low / Median / High Price $253.77 / $359.33 / $733.97	Professional		$253.77	$359.33	$733.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.22 / $95.69 / $197.43	Professional	26	$71.22	$95.69	$197.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $187.96 / $304.88 / $558.77	Professional	TC	$187.96	$304.88	$558.77
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $187.20 / $218.65 / $330.22	Professional		$187.20	$218.65	$330.22
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $49.04 / $60.81 / $79.06	Professional	26	$49.04	$60.81	$79.06
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $137.16 / $161.37 / $222.43	Professional	TC	$137.16	$161.37	$222.43