Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $57.54 / $323.59	Facility	26	$53.70	$57.54	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $208.93 / $562.34	Professional		$138.04	$208.93	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $53.70 / $154.88	Professional	26	$43.65	$53.70	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $120.23 / $309.03	Professional	TC	$81.28	$120.23	$309.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $190.55 / $478.63	Professional		$131.83	$190.55	$478.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $66.07 / $158.49	Professional	26	$46.77	$66.07	$158.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $123.03 / $316.23	Professional	TC	$85.11	$123.03	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $281.84 / $588.84	Professional		$169.82	$281.84	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $70.79 / $131.83	Professional	26	$52.48	$70.79	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $194.98 / $398.11	Professional	TC	$109.65	$194.98	$398.11
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $389.05	Professional		$158.49	$199.53	$389.05
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $70.79 / $141.25	Professional	26	$56.23	$70.79	$141.25
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $128.82 / $251.19	Professional	TC	$102.33	$128.82	$251.19
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $57.54 / $323.59	Facility	26	$53.70	$57.54	$323.59
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $218.78 / $489.78	Professional		$154.88	$218.78	$489.78
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $63.10 / $128.82	Professional	26	$45.71	$63.10	$128.82
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $138.04 / $331.13	Professional	TC	$100.00	$138.04	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $251.19 / $436.52	Professional		$147.91	$251.19	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $75.86 / $131.83	Professional	26	$48.98	$75.86	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $173.78 / $302.00	Professional	TC	$97.72	$173.78	$302.00