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 / $64.59	Facility	26	$64.59	$64.59	$64.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.80 / $332.37 / $400.99	Professional		$240.80	$332.37	$400.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.50 / $64.59 / $82.56	Professional	26	$59.50	$64.59	$82.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.13 / $248.48 / $334.93	Professional	TC	$168.13	$248.48	$334.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.38 / $256.72 / $379.41	Professional		$198.38	$256.72	$379.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.45 / $72.18 / $109.88	Professional	26	$55.45	$72.18	$109.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $140.06 / $184.54 / $269.52	Professional	TC	$140.06	$184.54	$269.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.34 / $357.12 / $596.97	Professional		$244.34	$357.12	$596.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.27 / $91.15 / $131.16	Professional	26	$66.27	$91.15	$131.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $176.04 / $255.00 / $450.00	Professional	TC	$176.04	$255.00	$450.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $226.30 / $272.32 / $491.25	Professional		$226.30	$272.32	$491.25
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $65.54 / $78.87 / $142.27	Professional	26	$65.54	$78.87	$142.27
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $160.76 / $193.45 / $348.98	Professional	TC	$160.76	$193.45	$348.98
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $222.37 / $321.24 / $475.51	Professional		$222.37	$321.24	$475.51
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $59.50 / $68.42 / $117.60	Professional	26	$59.50	$68.42	$117.60
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $168.13 / $229.37 / $342.60	Professional	TC	$168.13	$229.37	$342.60
United Facility/Professional Professional Modifier Low / Median / High Price $209.70 / $374.90 / $528.42	Professional		$209.70	$374.90	$528.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.77 / $98.62 / $142.27	Professional	26	$55.77	$98.62	$142.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.26 / $276.27 / $395.16	Professional	TC	$169.26	$276.27	$395.16