Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.23 / $64.59 / $73.59	Facility	26	$61.23	$64.59	$73.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.57 / $287.22 / $345.99	Professional		$173.57	$287.22	$345.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.06 / $62.26 / $82.56	Professional	26	$56.06	$62.26	$82.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $116.69 / $193.59 / $271.94	Professional	TC	$116.69	$193.59	$271.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.78 / $211.95 / $319.98	Professional		$163.78	$211.95	$319.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.45 / $72.00 / $109.88	Professional	26	$55.45	$72.00	$109.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $108.14 / $139.94 / $210.09	Professional	TC	$108.14	$139.94	$210.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.64 / $300.77 / $488.89	Professional		$200.64	$300.77	$488.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.28 / $86.99 / $119.36	Professional	26	$59.28	$86.99	$119.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.56 / $198.67 / $350.48	Professional	TC	$131.56	$198.67	$350.48
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $190.85 / $229.65 / $414.30	Professional		$190.85	$229.65	$414.30
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 $125.31 / $150.79 / $272.02	Professional	TC	$125.31	$150.79	$272.02
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $61.23 / $64.59 / $73.59	Facility	26	$61.23	$64.59	$73.59
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $183.04 / $257.74 / $353.25	Professional		$183.04	$257.74	$353.25
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $56.89 / $64.59 / $117.60	Professional	26	$56.89	$64.59	$117.60
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $119.13 / $168.81 / $271.94	Professional	TC	$119.13	$168.81	$271.94
United Facility/Professional Professional Modifier Low / Median / High Price $169.14 / $238.61 / $421.16	Professional		$169.14	$238.61	$421.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.77 / $80.68 / $142.27	Professional	26	$55.77	$80.68	$142.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.88 / $149.03 / $278.83	Professional	TC	$111.88	$149.03	$278.83