Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.00 / $167.00 / $167.00	Facility	26	$167.00	$167.00	$167.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $600.00	Professional		$370.50	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.49 / $140.00 / $167.00	Professional	26	$88.49	$140.00	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $433.00	Professional	TC	$259.35	$335.00	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $249.18 / $326.16 / $474.79	Professional		$249.18	$326.16	$474.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.96 / $86.40 / $130.62	Professional	26	$61.96	$86.40	$130.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $179.55 / $239.37 / $344.17	Professional	TC	$179.55	$239.37	$344.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $308.76 / $467.72 / $893.93	Professional		$308.76	$467.72	$893.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.39 / $101.81 / $143.27	Professional	26	$64.39	$101.81	$143.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $226.43 / $329.12 / $647.00	Professional	TC	$226.43	$329.12	$647.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $283.18 / $340.78 / $614.73	Professional		$283.18	$340.78	$614.73
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $77.91 / $93.74 / $169.13	Professional	26	$77.91	$93.74	$169.13
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $205.28 / $247.02 / $445.62	Professional	TC	$205.28	$247.02	$445.62
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $273.52 / $487.39 / $893.00	Professional		$273.52	$487.39	$893.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $70.22 / $140.00 / $167.00	Professional	26	$70.22	$140.00	$167.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $203.29 / $347.55 / $444.15	Professional	TC	$203.29	$347.55	$444.15
United Facility/Professional Professional Modifier Low / Median / High Price $244.72 / $476.40 / $653.15	Professional		$244.72	$476.40	$653.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.23 / $96.11 / $158.24	Professional	26	$66.23	$96.11	$158.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.33 / $376.14 / $489.23	Professional	TC	$196.33	$376.14	$489.23