Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.04 / $65.04 / $65.04	Facility	26	$65.04	$65.04	$65.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $305.60 / $348.04 / $445.94	Professional		$305.60	$348.04	$445.94
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $152.80 / $174.02 / $222.97	Professional	52	$152.80	$174.02	$222.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $265.75 / $303.33 / $381.11	Professional	TC	$265.75	$303.33	$381.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $361.31 / $526.22 / $840.74	Professional		$361.31	$526.22	$840.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $318.29 / $463.56 / $688.50	Professional	TC	$318.29	$463.56	$688.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $428.88 / $593.24 / $1,103.26	Professional		$428.88	$593.24	$1,103.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $366.86 / $516.46 / $972.47	Professional	TC	$366.86	$516.46	$972.47
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $413.63 / $681.87 / $1,276.67	Professional		$413.63	$681.87	$1,276.67
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $364.38 / $599.41 / $1,124.66	Professional	TC	$364.38	$599.41	$1,124.66
United Facility/Professional Professional Modifier Low / Median / High Price $392.23 / $536.54 / $1,202.30	Professional		$392.23	$536.54	$1,202.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $357.72 / $482.70 / $1,054.17	Professional	TC	$357.72	$482.70	$1,054.17
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $283.80 / $331.48 / $500.62	Professional		$283.80	$331.48	$500.62
Well Sense Facility/Professional Professional Modifier TC Low / Median / High Price $246.08 / $289.51 / $399.05	Professional	TC	$246.08	$289.51	$399.05