Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.26 / $167.00 / $167.00	Facility	26	$95.26	$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 $96.36 / $140.00 / $167.00	Professional	26	$96.36	$140.00	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $470.23	Professional	TC	$259.35	$335.00	$470.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $308.58 / $448.10 / $704.23	Professional		$308.58	$448.10	$704.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.13 / $93.14 / $142.37	Professional	26	$67.13	$93.14	$142.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $241.95 / $339.37 / $561.86	Professional	TC	$241.95	$339.37	$561.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $664.03 / $958.17	Professional		$467.74	$664.03	$958.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.70 / $111.19 / $155.22	Professional	26	$69.70	$111.19	$155.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $378.08 / $531.84 / $815.52	Professional	TC	$378.08	$531.84	$815.52
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $420.03 / $505.45 / $911.80	Professional		$420.03	$505.45	$911.80
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $84.91 / $102.18 / $184.32	Professional	26	$84.91	$102.18	$184.32
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $335.12 / $403.26 / $727.48	Professional	TC	$335.12	$403.26	$727.48
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $95.26 / $95.26 / $95.26	Facility	26	$95.26	$95.26	$95.26
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $381.84 / $546.25 / $762.10	Professional		$381.84	$546.25	$762.10
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $77.29 / $140.00 / $167.00	Professional	26	$77.29	$140.00	$167.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $297.50 / $408.20 / $522.03	Professional	TC	$297.50	$408.20	$522.03
United Facility/Professional Professional Modifier Low / Median / High Price $402.23 / $617.41 / $1,001.55	Professional		$402.23	$617.41	$1,001.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.33 / $104.20 / $172.84	Professional	26	$72.33	$104.20	$172.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $298.02 / $502.44 / $764.99	Professional	TC	$298.02	$502.44	$764.99