Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $106.80 / $283.51	Facility	26	$62.89	$106.80	$283.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $382.41 / $434.96 / $761.69	Professional		$382.41	$434.96	$761.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.42 / $58.77 / $104.37	Professional	26	$50.42	$58.77	$104.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $331.99 / $378.80 / $657.32	Professional	TC	$331.99	$378.80	$657.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $425.68 / $619.97 / $968.53	Professional		$425.68	$619.97	$968.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.34 / $79.14 / $117.54	Professional	26	$54.34	$79.14	$117.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $371.34 / $540.82 / $803.25	Professional	TC	$371.34	$540.82	$803.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $518.12 / $758.41 / $1,265.03	Professional		$518.12	$758.41	$1,265.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.69 / $105.20 / $193.39	Professional	26	$64.69	$105.20	$193.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $453.44 / $649.91 / $1,099.82	Professional	TC	$453.44	$649.91	$1,099.82
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $487.31 / $803.33 / $1,504.08	Professional		$487.31	$803.33	$1,504.08
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $62.21 / $102.34 / $192.01	Professional	26	$62.21	$102.34	$192.01
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $425.10 / $699.29 / $1,312.07	Professional	TC	$425.10	$699.29	$1,312.07
United Facility/Professional Professional Modifier Low / Median / High Price $487.31 / $748.82 / $1,423.96	Professional		$487.31	$748.82	$1,423.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.69 / $98.00 / $199.02	Professional	26	$66.69	$98.00	$199.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $425.10 / $591.77 / $1,234.90	Professional	TC	$425.10	$591.77	$1,234.90
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $335.82 / $392.24 / $592.39	Professional		$335.82	$392.24	$592.39
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $45.52 / $63.73 / $98.70	Professional	26	$45.52	$63.73	$98.70
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $288.20 / $339.07 / $495.14	Professional	TC	$288.20	$339.07	$495.14