Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.57 / $176.91 / $176.91	Facility	26	$84.57	$176.91	$176.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.75 / $197.13 / $466.23	Professional		$155.75	$197.13	$466.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $57.82 / $160.10	Professional	26	$53.70	$57.82	$160.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.58 / $140.91 / $306.13	Professional	TC	$101.58	$140.91	$306.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.38 / $321.86 / $451.27	Professional		$162.38	$321.86	$451.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.96 / $63.49 / $99.09	Professional	26	$55.96	$63.49	$99.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.42 / $258.37 / $362.26	Professional	TC	$106.42	$258.37	$362.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $329.67 / $537.99 / $842.36	Professional		$329.67	$537.99	$842.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.59 / $101.75 / $153.90	Professional	26	$64.59	$101.75	$153.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $264.98 / $442.70 / $701.65	Professional	TC	$264.98	$442.70	$701.65
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $324.75 / $561.75 / $1,002.34	Professional		$324.75	$561.75	$1,002.34
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $64.06 / $110.81 / $197.72	Professional	26	$64.06	$110.81	$197.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $260.69 / $450.94 / $804.62	Professional	TC	$260.69	$450.94	$804.62
United Facility/Professional Professional Modifier Low / Median / High Price $317.95 / $461.06 / $1,070.06	Professional		$317.95	$461.06	$1,070.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.74 / $99.83 / $204.38	Professional	26	$63.74	$99.83	$204.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $256.24 / $387.06 / $874.39	Professional	TC	$256.24	$387.06	$874.39
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $136.18 / $187.38 / $295.88	Professional		$136.18	$187.38	$295.88
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $46.38 / $55.19 / $73.09	Professional	26	$46.38	$55.19	$73.09
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $89.80 / $111.35 / $245.06	Professional	TC	$89.80	$111.35	$245.06