Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $18.62 / $20.89	Facility	26	$18.20	$18.62	$20.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $83.18 / $165.96	Professional		$56.23	$83.18	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $18.20 / $41.69	Professional	26	$12.02	$18.20	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $57.54 / $109.65	Professional	TC	$38.90	$57.54	$109.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $131.83	Professional		$64.57	$89.13	$131.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.50 / $28.84	Professional	26	$13.18	$19.50	$28.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $69.18 / $100.00	Professional	TC	$51.29	$69.18	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $91.20 / $162.18	Professional		$64.57	$91.20	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $20.89 / $37.15	Professional	26	$17.38	$20.89	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $69.18 / $125.89	Professional	TC	$48.98	$69.18	$125.89
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $109.65 / $204.17	Professional		$87.10	$109.65	$204.17
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $22.91 / $42.66	Professional	26	$18.20	$22.91	$42.66
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $87.10 / $162.18	Professional	TC	$69.18	$87.10	$162.18
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $18.62 / $20.89	Facility	26	$18.20	$18.62	$20.89
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $87.10 / $177.83	Professional		$60.26	$87.10	$177.83
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $19.95 / $39.81	Professional	26	$14.45	$19.95	$39.81
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $69.18 / $131.83	Professional	TC	$44.67	$69.18	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $91.20 / $173.78	Professional		$63.10	$91.20	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $22.91 / $41.69	Professional	26	$15.85	$22.91	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $70.79 / $128.82	Professional	TC	$46.77	$70.79	$128.82