Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.29 / $92.29 / $93.01	Facility	26	$92.29	$92.29	$93.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.74 / $340.04 / $410.06	Professional		$258.74	$340.04	$410.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $72.55 / $116.31	Professional	26	$62.17	$72.55	$116.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.61 / $277.86 / $341.05	Professional	TC	$181.61	$277.86	$341.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.24 / $309.60 / $464.42	Professional		$239.24	$309.60	$464.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.97 / $103.49 / $156.88	Professional	26	$79.97	$103.49	$156.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $159.26 / $206.10 / $307.54	Professional	TC	$159.26	$206.10	$307.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.41 / $431.06 / $654.34	Professional		$295.41	$431.06	$654.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.31 / $121.92 / $171.77	Professional	26	$69.31	$121.92	$171.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $195.56 / $291.02 / $481.76	Professional	TC	$195.56	$291.02	$481.76
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $277.00 / $333.33 / $601.30	Professional		$277.00	$333.33	$601.30
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $93.57 / $112.60 / $203.12	Professional	26	$93.57	$112.60	$203.12
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $183.43 / $220.73 / $398.19	Professional	TC	$183.43	$220.73	$398.19
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $92.29 / $92.29 / $93.01	Facility	26	$92.29	$92.29	$93.01
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $266.00 / $354.22 / $478.50	Professional		$266.00	$354.22	$478.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $65.54 / $93.01 / $167.97	Professional	26	$65.54	$93.01	$167.97
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $181.61 / $277.86 / $341.05	Professional	TC	$181.61	$277.86	$341.05
United Facility/Professional Professional Modifier Low / Median / High Price $247.81 / $377.58 / $601.30	Professional		$247.81	$377.58	$601.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.37 / $108.26 / $203.12	Professional	26	$83.37	$108.26	$203.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.29 / $282.36 / $398.19	Professional	TC	$165.29	$282.36	$398.19