Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.00 / $167.00 / $167.00	Facility	26	$167.00	$167.00	$167.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $600.00	Professional		$370.50	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.27 / $140.00 / $167.00	Professional	26	$97.27	$140.00	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $433.00	Professional	TC	$259.35	$335.00	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $284.14 / $382.06 / $550.80	Professional		$284.14	$382.06	$550.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.45 / $94.05 / $143.06	Professional	26	$67.45	$94.05	$143.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $208.17 / $288.00 / $407.75	Professional	TC	$208.17	$288.00	$407.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.51 / $518.60 / $943.28	Professional		$365.51	$518.60	$943.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.81 / $110.36 / $156.76	Professional	26	$70.81	$110.36	$156.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $274.94 / $404.57 / $647.00	Professional	TC	$274.94	$404.57	$647.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $328.52 / $395.33 / $713.15	Professional		$328.52	$395.33	$713.15
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $85.33 / $102.68 / $185.23	Professional	26	$85.33	$102.68	$185.23
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $243.20 / $292.64 / $527.94	Professional	TC	$243.20	$292.64	$527.94
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $494.18 / $709.36	Professional		$370.50	$494.18	$709.36
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $97.27 / $140.00 / $167.00	Professional	26	$97.27	$140.00	$167.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $357.37 / $433.00	Professional	TC	$259.35	$357.37	$433.00
United Facility/Professional Professional Modifier Low / Median / High Price $288.97 / $438.56 / $728.74	Professional		$288.97	$438.56	$728.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.84 / $116.13 / $185.23	Professional	26	$74.84	$116.13	$185.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $215.91 / $329.51 / $569.86	Professional	TC	$215.91	$329.51	$569.86