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 $111.15 / $140.00 / $167.00	Professional	26	$111.15	$140.00	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $280.01 / $335.00 / $446.53	Professional	TC	$280.01	$335.00	$446.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $367.71 / $481.47 / $700.08	Professional		$367.71	$481.47	$700.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.29 / $114.30 / $174.16	Professional	26	$82.29	$114.30	$174.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $274.83 / $365.90 / $525.92	Professional	TC	$274.83	$365.90	$525.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $455.76 / $659.36 / $990.73	Professional		$455.76	$659.36	$990.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.05 / $135.91 / $190.87	Professional	26	$87.05	$135.91	$190.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $345.25 / $497.55 / $791.21	Professional	TC	$345.25	$497.55	$791.21
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $417.56 / $502.47 / $906.44	Professional		$417.56	$502.47	$906.44
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $103.87 / $125.00 / $225.48	Professional	26	$103.87	$125.00	$225.48
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $313.68 / $377.48 / $680.94	Professional	TC	$313.68	$377.48	$680.94
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $404.04 / $570.55 / $878.62	Professional		$404.04	$570.55	$878.62
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $93.58 / $145.65 / $186.50	Professional	26	$93.58	$145.65	$186.50
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $297.50 / $433.00 / $530.90	Professional	TC	$297.50	$433.00	$530.90
United Facility/Professional Professional Modifier Low / Median / High Price $390.13 / $594.19 / $969.36	Professional		$390.13	$594.19	$969.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.49 / $127.95 / $225.48	Professional	26	$88.49	$127.95	$225.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $271.33 / $410.54 / $696.42	Professional	TC	$271.33	$410.54	$696.42