Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	26	$138.04	$138.04	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $120.23	Professional		$72.44	$85.11	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $44.67 / $91.20	Professional	26	$38.02	$44.67	$91.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $40.74 / $63.10	Professional	TC	$33.11	$40.74	$63.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $223.87	Professional		$91.20	$141.25	$223.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $67.61 / $112.20	Professional	26	$43.65	$67.61	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $67.61 / $109.65	Professional	TC	$45.71	$67.61	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $147.91 / $281.84	Professional		$81.28	$147.91	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $77.62 / $147.91	Professional	26	$50.12	$77.62	$147.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $70.79 / $134.90	Professional	TC	$36.31	$70.79	$134.90
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $128.82 / $234.42	Professional		$63.10	$128.82	$234.42
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $79.43 / $117.49	Professional	26	$48.98	$79.43	$117.49
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $83.18 / $123.03	Professional	TC	$50.12	$83.18	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $138.04 / $269.15	Professional		$89.13	$138.04	$269.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $70.79 / $125.89	Professional	26	$48.98	$70.79	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $66.07 / $120.23	Professional	TC	$40.74	$66.07	$120.23
Well Sense Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $27.54 / $33.11	Facility	26	$27.54	$27.54	$33.11