Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $311.72 / $311.72 / $546.89	Facility	26	$311.72	$311.72	$546.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,087.58 / $1,091.01 / $1,304.00	Professional		$1,087.58	$1,091.01	$1,304.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $289.50 / $311.72 / $366.45	Professional	26	$289.50	$311.72	$366.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $775.87 / $801.50 / $937.53	Professional	TC	$775.87	$801.50	$937.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,133.78 / $2,183.62 / $3,587.56	Professional		$1,133.78	$2,183.62	$3,587.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $277.52 / $591.76 / $1,006.83	Professional	26	$277.52	$591.76	$1,006.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $685.42 / $1,527.28 / $2,486.56	Professional	TC	$685.42	$1,527.28	$2,486.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,475.93 / $2,481.75 / $3,773.21	Professional		$1,475.93	$2,481.75	$3,773.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $414.02 / $662.44 / $1,007.16	Professional	26	$414.02	$662.44	$1,007.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,061.91 / $1,819.31 / $2,766.05	Professional	TC	$1,061.91	$1,819.31	$2,766.05
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $1,135.45 / $2,201.34 / $3,922.16	Professional		$1,135.45	$2,201.34	$3,922.16
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $317.85 / $606.80 / $1,046.59	Professional	26	$317.85	$606.80	$1,046.59
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $784.98 / $1,498.64 / $2,584.78	Professional	TC	$784.98	$1,498.64	$2,584.78
United Facility/Professional Professional Modifier Low / Median / High Price $1,472.68 / $2,060.96 / $3,922.16	Professional		$1,472.68	$2,060.96	$3,922.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $404.64 / $592.58 / $1,041.18	Professional	26	$404.64	$592.58	$1,041.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,068.04 / $1,468.38 / $2,465.94	Professional	TC	$1,068.04	$1,468.38	$2,465.94
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $892.25 / $1,070.70 / $1,521.93	Professional		$892.25	$1,070.70	$1,521.93
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $229.70 / $275.64 / $397.14	Professional	26	$229.70	$275.64	$397.14
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $633.07 / $759.68 / $1,044.56	Professional	TC	$633.07	$759.68	$1,044.56