Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $481.75 / $481.75 / $1,307.55	Facility		$481.75	$481.75	$1,307.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.65 / $162.65 / $162.65	Facility	26	$162.65	$162.65	$162.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $341.43 / $481.75 / $597.26	Professional		$341.43	$481.75	$597.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.31 / $162.65 / $190.72	Professional	26	$127.31	$162.65	$190.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $214.11 / $319.08 / $406.52	Professional	TC	$214.11	$319.08	$406.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.98 / $506.67 / $732.69	Professional		$426.98	$506.67	$732.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $141.94 / $166.99 / $253.99	Professional	26	$141.94	$166.99	$253.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $278.58 / $334.63 / $496.61	Professional	TC	$278.58	$334.63	$496.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $444.92 / $608.80 / $872.23	Professional		$444.92	$608.80	$872.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $158.44 / $193.64 / $268.70	Professional	26	$158.44	$193.64	$268.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $279.10 / $421.25 / $603.52	Professional	TC	$279.10	$421.25	$603.52
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $398.44 / $513.16 / $787.22	Professional		$398.44	$513.16	$787.22
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $138.12 / $177.89 / $272.89	Professional	26	$138.12	$177.89	$272.89
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $260.32 / $335.28 / $514.33	Professional	TC	$260.32	$335.28	$514.33
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,307.55 / $1,307.55 / $1,307.55	Facility		$1,307.55	$1,307.55	$1,307.55
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $370.30 / $481.75 / $677.97	Professional		$370.30	$481.75	$677.97
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $127.31 / $162.65 / $229.90	Professional	26	$127.31	$162.65	$229.90
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $237.40 / $319.08 / $448.07	Professional	TC	$237.40	$319.08	$448.07
United Facility/Professional Professional Modifier Low / Median / High Price $356.15 / $513.54 / $781.93	Professional		$356.15	$513.54	$781.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $139.10 / $180.68 / $245.94	Professional	26	$139.10	$180.68	$245.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $255.26 / $345.06 / $535.99	Professional	TC	$255.26	$345.06	$535.99