Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.67 / $48.67 / $231.19	Facility	26	$48.67	$48.67	$231.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.70 / $178.59 / $214.93	Professional		$119.70	$178.59	$214.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.46 / $42.90 / $68.69	Professional	26	$36.46	$42.90	$68.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.48 / $130.63 / $174.41	Professional	TC	$76.48	$130.63	$174.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.36 / $146.69 / $224.61	Professional		$113.36	$146.69	$224.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.87 / $54.36 / $82.93	Professional	26	$41.87	$54.36	$82.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.28 / $92.25 / $141.68	Professional	TC	$71.28	$92.25	$141.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.13 / $211.56 / $347.00	Professional		$139.13	$211.56	$347.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.89 / $64.62 / $89.84	Professional	26	$40.89	$64.62	$89.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $86.72 / $134.05 / $273.00	Professional	TC	$86.72	$134.05	$273.00
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $126.16 / $147.18 / $194.00	Professional		$126.16	$147.18	$194.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $133.97 / $155.00 / $290.82	Professional		$133.97	$155.00	$290.82
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $49.46 / $59.52 / $107.37	Professional	26	$49.46	$59.52	$107.37
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $84.50 / $101.69 / $183.43	Professional	TC	$84.50	$101.69	$183.43
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $46.18 / $48.73 / $239.25	Facility	26	$46.18	$48.73	$239.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $128.22 / $171.41 / $231.73	Professional		$128.22	$171.41	$231.73
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $38.67 / $48.68 / $84.35	Professional	26	$38.67	$48.68	$84.35
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $80.38 / $111.85 / $174.41	Professional	TC	$80.38	$111.85	$174.41
United Facility/Professional Professional Modifier Low / Median / High Price $117.29 / $175.01 / $290.66	Professional		$117.29	$175.01	$290.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.67 / $61.05 / $100.45	Professional	26	$43.67	$61.05	$100.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.62 / $103.07 / $183.39	Professional	TC	$73.62	$103.07	$183.39