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 $79.59 / $140.00 / $167.00	Professional	26	$79.59	$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 $272.14 / $352.18 / $518.33	Professional		$272.14	$352.18	$518.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.41 / $96.30 / $145.82	Professional	26	$74.41	$96.30	$145.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $195.63 / $255.35 / $372.50	Professional	TC	$195.63	$255.35	$372.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $328.10 / $504.43 / $943.28	Professional		$328.10	$504.43	$943.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.56 / $97.83 / $159.81	Professional	26	$57.56	$97.83	$159.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $236.38 / $374.33 / $730.00	Professional	TC	$236.38	$374.33	$730.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $309.14 / $372.02 / $671.10	Professional		$309.14	$372.02	$671.10
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $86.97 / $104.67 / $188.79	Professional	26	$86.97	$104.67	$188.79
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $257.06 / $345.71 / $512.46	Professional	TC	$257.06	$345.71	$512.46
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $298.22 / $494.18 / $909.07	Professional		$298.22	$494.18	$909.07
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $78.36 / $140.00 / $167.00	Professional	26	$78.36	$140.00	$167.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $219.86 / $338.49 / $433.00	Professional	TC	$219.86	$338.49	$433.00
United Facility/Professional Professional Modifier Low / Median / High Price $258.17 / $557.15 / $720.45	Professional		$258.17	$557.15	$720.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.11 / $86.07 / $177.04	Professional	26	$74.11	$86.07	$177.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $184.06 / $471.08 / $609.15	Professional	TC	$184.06	$471.08	$609.15