Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Facility	26	$154.88	$154.88	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $416.87	Professional		$125.89	$162.18	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $51.29 / $144.54	Professional	26	$39.81	$51.29	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $112.20 / $251.19	Professional	TC	$85.11	$112.20	$251.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $346.74 / $489.78	Professional		$138.04	$346.74	$489.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $109.65 / $154.88	Professional	26	$42.66	$109.65	$154.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $239.88 / $338.84	Professional	TC	$95.50	$239.88	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $263.03 / $407.38	Professional		$162.18	$263.03	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $81.28 / $125.89	Professional	26	$48.98	$81.28	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $190.55 / $295.12	Professional	TC	$112.20	$190.55	$295.12
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $234.42 / $371.54	Professional		$151.36	$234.42	$371.54
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $77.62 / $114.82	Professional	26	$50.12	$77.62	$114.82
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $173.78 / $257.04	Professional	TC	$114.82	$173.78	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $251.19 / $446.68	Professional		$151.36	$251.19	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $72.44 / $134.90	Professional	26	$47.86	$72.44	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $177.83 / $302.00	Professional	TC	$104.71	$177.83	$302.00