Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.59 / $64.59 / $73.59	Facility	26	$64.59	$64.59	$73.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.50 / $232.72 / $280.01	Professional		$166.50	$232.72	$280.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.57 / $54.71 / $81.50	Professional	26	$48.57	$54.71	$81.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.61 / $184.15 / $226.00	Professional	TC	$109.61	$184.15	$226.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.31 / $207.46 / $312.38	Professional		$160.31	$207.46	$312.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.82 / $72.62 / $109.88	Professional	26	$55.82	$72.62	$109.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.97 / $134.55 / $202.49	Professional	TC	$103.97	$134.55	$202.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.35 / $293.58 / $433.36	Professional		$195.35	$293.58	$433.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.52 / $85.39 / $120.12	Professional	26	$54.52	$85.39	$120.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.85 / $191.46 / $327.00	Professional	TC	$125.85	$191.46	$327.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $186.31 / $223.22 / $404.44	Professional		$186.31	$223.22	$404.44
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $65.54 / $76.89 / $151.16	Professional	26	$65.54	$76.89	$151.16
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $120.77 / $147.34 / $278.56	Professional	TC	$120.77	$147.34	$278.56
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $73.59 / $73.59 / $73.59	Facility	26	$73.59	$73.59	$73.59
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $178.55 / $242.49 / $360.04	Professional		$178.55	$242.49	$360.04
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $51.16 / $64.59 / $131.63	Professional	26	$51.16	$64.59	$131.63
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $119.43 / $183.84 / $229.28	Professional	TC	$119.43	$183.84	$229.28
United Facility/Professional Professional Modifier Low / Median / High Price $165.16 / $227.30 / $404.44	Professional		$165.16	$227.30	$404.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.16 / $80.68 / $133.27	Professional	26	$57.16	$80.68	$133.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.10 / $148.86 / $268.92	Professional	TC	$98.10	$148.86	$268.92