Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.42 / $248.66 / $248.66	Facility	26	$84.42	$248.66	$248.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $308.27 / $486.23 / $563.95	Professional		$308.27	$486.23	$563.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.32 / $58.78 / $95.20	Professional	26	$50.32	$58.78	$95.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $154.13 / $243.12 / $281.98	Professional	52	$154.13	$243.12	$281.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.94 / $427.46 / $480.57	Professional	TC	$257.94	$427.46	$480.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $401.74 / $585.11 / $948.67	Professional		$401.74	$585.11	$948.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.96 / $81.50 / $122.32	Professional	26	$55.96	$81.50	$122.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $345.78 / $503.61 / $785.62	Professional	TC	$345.78	$503.61	$785.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $488.80 / $744.52 / $1,169.21	Professional		$488.80	$744.52	$1,169.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.56 / $106.72 / $191.05	Professional	26	$66.56	$106.72	$191.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $422.24 / $635.61 / $998.17	Professional	TC	$422.24	$635.61	$998.17
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $459.91 / $758.16 / $1,419.51	Professional		$459.91	$758.16	$1,419.51
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $64.06 / $105.38 / $197.72	Professional	26	$64.06	$105.38	$197.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $395.85 / $651.16 / $1,221.79	Professional	TC	$395.85	$651.16	$1,221.79
United Facility/Professional Professional Modifier Low / Median / High Price $484.71 / $664.12 / $1,396.66	Professional		$484.71	$664.12	$1,396.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.48 / $102.02 / $207.17	Professional	26	$69.48	$102.02	$207.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $413.06 / $585.74 / $1,189.49	Professional	TC	$413.06	$585.74	$1,189.49
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $329.25 / $362.18 / $460.95	Professional		$329.25	$362.18	$460.95
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $47.01 / $52.09 / $66.29	Professional	26	$47.01	$52.09	$66.29
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $281.89 / $310.08 / $394.65	Professional	TC	$281.89	$310.08	$394.65