Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.84 / $265.36 / $265.36	Facility	26	$122.84	$265.36	$265.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $335.55 / $412.07 / $594.63	Professional		$335.55	$412.07	$594.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.66 / $88.34 / $122.06	Professional	26	$76.66	$88.34	$122.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $267.24 / $327.18 / $483.35	Professional	TC	$267.24	$327.18	$483.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $429.88 / $626.09 / $993.95	Professional		$429.88	$626.09	$993.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.19 / $118.25 / $184.10	Professional	26	$81.19	$118.25	$184.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $348.70 / $507.85 / $754.28	Professional	TC	$348.70	$507.85	$754.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.04 / $680.95 / $1,297.59	Professional		$342.04	$680.95	$1,297.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.86 / $148.55 / $247.79	Professional	26	$96.86	$148.55	$247.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $278.83 / $536.55 / $1,049.82	Professional	TC	$278.83	$536.55	$1,049.82
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $492.13 / $809.55 / $1,518.96	Professional		$492.13	$809.55	$1,518.96
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $92.95 / $152.90 / $286.89	Professional	26	$92.95	$152.90	$286.89
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $399.18 / $656.65 / $1,232.07	Professional	TC	$399.18	$656.65	$1,232.07
United Facility/Professional Professional Modifier Low / Median / High Price $390.92 / $625.82 / $1,413.87	Professional		$390.92	$625.82	$1,413.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.85 / $145.60 / $295.68	Professional	26	$98.85	$145.60	$295.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $315.86 / $476.84 / $1,106.67	Professional	TC	$315.86	$476.84	$1,106.67
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $308.05 / $385.07 / $582.41	Professional		$308.05	$385.07	$582.41
Well Sense Facility/Professional Professional Modifier 26 Low / Median / High Price $67.81 / $81.37 / $109.17	Professional	26	$67.81	$81.37	$109.17
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $231.36 / $301.73 / $422.39	Professional	TC	$231.36	$301.73	$422.39