Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.58 / $49.09 / $55.97	Facility	26	$46.58	$49.09	$55.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.63 / $226.80 / $272.68	Professional		$144.63	$226.80	$272.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.22 / $51.79 / $69.70	Professional	26	$43.22	$51.79	$69.70
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $69.89 / $79.64 / $118.17	Professional	52	$69.89	$79.64	$118.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.43 / $177.61 / $211.27	Professional	TC	$101.43	$177.61	$211.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.31 / $176.40 / $269.52	Professional		$136.31	$176.40	$269.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.25 / $54.82 / $83.62	Professional	26	$42.25	$54.82	$83.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.89 / $121.50 / $185.91	Professional	TC	$93.89	$121.50	$185.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.66 / $253.65 / $443.72	Professional		$167.66	$253.65	$443.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.84 / $66.17 / $108.66	Professional	26	$51.84	$66.17	$108.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.25 / $175.97 / $325.49	Professional	TC	$115.25	$175.97	$325.49
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $160.76 / $193.45 / $348.98	Professional		$160.76	$193.45	$348.98
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $49.88 / $60.02 / $108.28	Professional	26	$49.88	$60.02	$108.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $110.88 / $133.43 / $240.70	Professional	TC	$110.88	$133.43	$240.70
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $46.58 / $49.09 / $298.17	Facility	26	$46.58	$49.09	$298.17
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $154.81 / $216.71 / $278.51	Professional		$154.81	$216.71	$278.51
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $46.58 / $54.70 / $92.91	Professional	26	$46.58	$54.70	$92.91
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $69.89 / $79.64 / $118.17	Professional	52	$69.89	$79.64	$118.17
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $105.52 / $146.82 / $217.98	Professional	TC	$105.52	$146.82	$217.98
United Facility/Professional Professional Modifier Low / Median / High Price $141.47 / $228.83 / $342.96	Professional		$141.47	$228.83	$342.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.38 / $61.05 / $108.17	Professional	26	$42.38	$61.05	$108.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.58 / $131.96 / $240.70	Professional	TC	$88.58	$131.96	$240.70