Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.75 / $66.23 / $70.31	Facility	26	$61.75	$66.23	$70.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.91 / $221.75 / $267.14	Professional		$162.91	$221.75	$267.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $51.71 / $83.12	Professional	26	$44.14	$51.71	$83.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $72.23 / $90.46 / $115.52	Professional	52	$72.23	$90.46	$115.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.10 / $161.26 / $217.98	Professional	TC	$109.10	$161.26	$217.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.07 / $187.74 / $279.89	Professional		$145.07	$187.74	$279.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.47 / $69.43 / $105.05	Professional	26	$53.47	$69.43	$105.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $90.65 / $118.31 / $174.85	Professional	TC	$90.65	$118.31	$174.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.73 / $265.62 / $441.00	Professional		$174.73	$265.62	$441.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.30 / $83.82 / $114.78	Professional	26	$55.30	$83.82	$114.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.32 / $165.49 / $341.00	Professional	TC	$108.32	$165.49	$341.00
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $216.00 / $216.00 / $216.00	Professional		$216.00	$216.00	$216.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $166.94 / $200.89 / $362.39	Professional		$166.94	$200.89	$362.39
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $62.65 / $73.50 / $144.50	Professional	26	$62.65	$73.50	$144.50
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $104.29 / $125.50 / $226.39	Professional	TC	$104.29	$125.50	$226.39
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $58.51 / $66.23 / $71.25	Facility	26	$58.51	$66.23	$71.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $159.74 / $221.75 / $288.94	Professional		$159.74	$221.75	$288.94
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $46.89 / $66.23 / $112.38	Professional	26	$46.89	$66.23	$112.38
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $72.23 / $90.46 / $115.52	Professional	52	$72.23	$90.46	$115.52
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $100.75 / $138.07 / $219.53	Professional	TC	$100.75	$138.07	$219.53
United Facility/Professional Professional Modifier Low / Median / High Price $160.10 / $255.89 / $373.29	Professional		$160.10	$255.89	$373.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.18 / $73.06 / $140.94	Professional	26	$57.18	$73.06	$140.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $101.41 / $176.38 / $252.71	Professional	TC	$101.41	$176.38	$252.71