Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.39 / $147.80 / $147.80	Facility	26	$65.39	$147.80	$147.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.36 / $100.70 / $131.10	Professional		$88.36	$100.70	$131.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.88 / $53.71 / $63.00	Professional	TC	$46.88	$53.71	$63.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.04 / $125.31 / $203.16	Professional		$86.04	$125.31	$203.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.70 / $62.19 / $97.02	Professional	TC	$42.70	$62.19	$97.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.01 / $169.44 / $289.98	Professional		$88.01	$169.44	$289.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.80 / $84.48 / $156.47	Professional	TC	$44.80	$84.48	$156.47
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $92.61 / $154.77 / $304.02	Professional		$92.61	$154.77	$304.02
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $48.88 / $76.90 / $138.46	Professional	TC	$48.88	$76.90	$138.46
United Facility/Professional Professional Modifier Low / Median / High Price $97.15 / $144.65 / $335.71	Professional		$97.15	$144.65	$335.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.57 / $76.81 / $172.14	Professional	TC	$50.57	$76.81	$172.14
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $78.19 / $86.01 / $109.47	Professional		$78.19	$86.01	$109.47
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $40.49 / $44.86 / $57.09	Professional	TC	$40.49	$44.86	$57.09