Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.81 / $377.46 / $979.29	Facility		$173.81	$377.46	$979.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.47 / $69.05 / $69.05	Facility	26	$33.47	$69.05	$69.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.90 / $124.21 / $220.81	Professional		$123.90	$124.21	$220.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.10 / $22.97 / $42.54	Professional	26	$22.10	$22.97	$42.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.24 / $101.81 / $166.46	Professional	TC	$101.24	$101.81	$166.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.89 / $128.08 / $221.02	Professional		$112.89	$128.08	$221.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.32 / $25.32 / $40.54	Professional	26	$22.32	$25.32	$40.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $90.57 / $102.76 / $172.14	Professional	TC	$90.57	$102.76	$172.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $441.73 / $641.72 / $802.55	Facility		$441.73	$641.72	$802.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.75 / $225.87 / $326.72	Professional		$132.75	$225.87	$326.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.56 / $38.76 / $62.84	Professional	26	$25.56	$38.76	$62.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.19 / $182.94 / $263.88	Professional	TC	$107.19	$182.94	$263.88
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $129.22 / $229.67 / $425.70	Professional		$129.22	$229.67	$425.70
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $44.20 / $78.86	Professional	26	$25.55	$44.20	$78.86
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $103.68 / $184.26 / $341.53	Professional	TC	$103.68	$184.26	$341.53
United Facility/Professional Professional Modifier Low / Median / High Price $140.46 / $204.30 / $414.89	Professional		$140.46	$204.30	$414.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.44 / $35.61 / $83.33	Professional	26	$25.44	$35.61	$83.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.52 / $172.78 / $332.23	Professional	TC	$114.52	$172.78	$332.23
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $107.29 / $130.16 / $184.74	Professional		$107.29	$130.16	$184.74
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $18.66 / $21.95 / $28.19	Professional	26	$18.66	$21.95	$28.19
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $78.75 / $97.65 / $149.15	Professional	TC	$78.75	$97.65	$149.15