Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.96 / $57.25 / $64.84	Facility	26	$56.96	$57.25	$64.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.19 / $221.75 / $267.14	Professional		$171.19	$221.75	$267.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $51.59 / $78.73	Professional	26	$44.14	$51.59	$78.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $110.40 / $160.94 / $217.98	Professional	TC	$110.40	$160.94	$217.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.24 / $184.08 / $273.68	Professional		$142.24	$184.08	$273.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.70 / $64.40 / $96.75	Professional	26	$49.70	$64.40	$96.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.71 / $119.68 / $176.92	Professional	TC	$91.71	$119.68	$176.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.98 / $260.64 / $441.00	Professional		$174.98	$260.64	$441.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.16 / $77.69 / $106.37	Professional	26	$54.16	$77.69	$106.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.11 / $173.59 / $341.00	Professional	TC	$114.11	$173.59	$341.00
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $185.75 / $185.75 / $185.75	Professional		$185.75	$185.75	$185.75
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $163.22 / $196.42 / $354.34	Professional		$163.22	$196.42	$354.34
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $57.71 / $69.44 / $125.28	Professional	26	$57.71	$69.44	$125.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $105.52 / $126.99 / $229.06	Professional	TC	$105.52	$126.99	$229.06
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $53.97 / $57.25 / $65.73	Facility	26	$53.97	$57.25	$65.73
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $156.61 / $208.84 / $282.33	Professional		$156.61	$208.84	$282.33
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $46.89 / $57.25 / $98.59	Professional	26	$46.89	$57.25	$98.59
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $101.95 / $136.51 / $221.14	Professional	TC	$101.95	$136.51	$221.14
United Facility/Professional Professional Modifier Low / Median / High Price $158.07 / $253.99 / $367.41	Professional		$158.07	$253.99	$367.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.66 / $76.62 / $118.12	Professional	26	$50.66	$76.62	$118.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.12 / $175.41 / $266.23	Professional	TC	$97.12	$175.41	$266.23