Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	26	$165.96	$165.96	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $575.44 / $2,290.87	Professional		$371.54	$575.44	$2,290.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $151.36 / $338.84	Professional	26	$109.65	$151.36	$338.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $436.52 / $912.01	Professional	TC	$263.03	$436.52	$912.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $691.83 / $1,737.80	Professional		$457.09	$691.83	$1,737.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $151.36 / $354.81	Professional	26	$104.71	$151.36	$354.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $537.03 / $1,380.38	Professional	TC	$354.81	$537.03	$1,380.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,000.00 / $1,698.24	Professional		$660.69	$1,000.00	$1,698.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $144.54 / $302.00	Professional	26	$107.15	$144.54	$302.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $851.14 / $1,445.44	Professional	TC	$457.09	$851.14	$1,445.44
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $707.95 / $1,412.54	Professional		$562.34	$707.95	$1,412.54
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $158.49 / $295.12	Professional	26	$125.89	$158.49	$295.12
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $549.54 / $1,096.48	Professional	TC	$436.52	$549.54	$1,096.48
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $741.31 / $1,621.81	Professional		$426.58	$741.31	$1,621.81
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $173.78 / $338.84	Professional	26	$112.20	$173.78	$338.84
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $537.03 / $1,174.90	Professional	TC	$295.12	$537.03	$1,174.90
United Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $812.83 / $1,584.89	Professional		$512.86	$812.83	$1,584.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $162.18 / $288.40	Professional	26	$112.20	$162.18	$288.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $630.96 / $1,258.93	Professional	TC	$407.38	$630.96	$1,258.93