Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.89 / $403.56 / $513.67	Facility		$49.89	$403.56	$513.67
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.80 / $12.80 / $57.31	Facility	26	$12.80	$12.80	$57.31
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.23 / $106.28 / $441.32	Facility	TC	$30.23	$106.28	$441.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $43.04 / $72.54	Professional		$36.65	$43.04	$72.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $11.47 / $19.17	Professional	26	$10.02	$11.47	$19.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.62 / $30.23 / $51.07	Professional	TC	$26.62	$30.23	$51.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.26 / $148.15 / $243.15	Facility		$107.26	$148.15	$243.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.49 / $52.82 / $76.31	Professional		$38.49	$52.82	$76.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $14.60 / $20.34	Professional	26	$10.35	$14.60	$20.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.14 / $37.57 / $55.94	Professional	TC	$28.14	$37.57	$55.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.08 / $56.00 / $88.82	Professional		$37.08	$56.00	$88.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $17.14 / $25.06	Professional	26	$10.23	$17.14	$25.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.31 / $39.95 / $65.02	Professional	TC	$26.31	$39.95	$65.02
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $412.00 / $412.00 / $412.00	Facility		$412.00	$412.00	$412.00
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $35.00 / $35.00	Professional		$35.00	$35.00	$35.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $49.05 / $59.02 / $106.48	Professional		$49.05	$59.02	$106.48
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $15.88 / $28.63	Professional	26	$13.19	$15.88	$28.63
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $35.86 / $43.16 / $82.71	Professional	TC	$35.86	$43.16	$82.71
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $49.89 / $391.50 / $588.71	Facility		$49.89	$391.50	$588.71
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.32 / $12.97 / $60.95	Facility	26	$12.32	$12.97	$60.95
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $30.24 / $113.31 / $467.87	Facility	TC	$30.24	$113.31	$467.87
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $40.90 / $47.07 / $77.27	Professional		$40.90	$47.07	$77.27
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $10.75 / $12.80 / $22.45	Professional	26	$10.75	$12.80	$22.45
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $29.82 / $33.86 / $55.30	Professional	TC	$29.82	$33.86	$55.30
United Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $49.05 / $89.60	Professional		$38.61	$49.05	$89.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.13 / $16.04 / $26.65	Professional	26	$11.13	$16.04	$26.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.96 / $33.28 / $67.23	Professional	TC	$26.96	$33.28	$67.23