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 $167.73 / $221.75 / $267.14	Professional		$167.73	$221.75	$267.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $49.16 / $72.75	Professional	26	$44.14	$49.16	$72.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.06 / $177.61 / $217.98	Professional	TC	$117.06	$177.61	$217.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.88 / $183.63 / $272.98	Professional		$141.88	$183.63	$272.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.70 / $64.34 / $96.75	Professional	26	$49.70	$64.34	$96.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.36 / $119.21 / $176.23	Professional	TC	$91.36	$119.21	$176.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.69 / $260.00 / $441.00	Professional		$170.69	$260.00	$441.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.01 / $75.98 / $106.37	Professional	26	$53.01	$75.98	$106.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.14 / $172.94 / $341.00	Professional	TC	$109.14	$172.94	$341.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $162.82 / $195.93 / $353.45	Professional		$162.82	$195.93	$353.45
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 $105.11 / $126.49 / $228.17	Professional	TC	$105.11	$126.49	$228.17
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $56.96 / $57.25 / $64.84	Facility	26	$56.96	$57.25	$64.84
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $156.21 / $221.75 / $339.70	Professional		$156.21	$221.75	$339.70
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $46.49 / $57.25 / $103.67	Professional	26	$46.49	$57.25	$103.67
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $104.10 / $150.04 / $221.22	Professional	TC	$104.10	$150.04	$221.22
United Facility/Professional Professional Modifier Low / Median / High Price $157.58 / $253.35 / $367.41	Professional		$157.58	$253.35	$367.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.43 / $71.54 / $118.12	Professional	26	$49.43	$71.54	$118.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.11 / $173.35 / $266.23	Professional	TC	$105.11	$173.35	$266.23