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 / $297.26	Facility	26	$56.96	$57.25	$297.26
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 / $50.67 / $76.68	Professional	26	$44.14	$50.67	$76.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.54 / $161.90 / $217.98	Professional	TC	$109.54	$161.90	$217.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.54 / $183.17 / $272.29	Professional		$141.54	$183.17	$272.29
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 $90.65 / $118.77 / $175.54	Professional	TC	$90.65	$118.77	$175.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.11 / $259.35 / $441.00	Professional		$174.11	$259.35	$441.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.01 / $77.69 / $106.37	Professional	26	$53.01	$77.69	$106.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.24 / $172.30 / $341.00	Professional	TC	$113.24	$172.30	$341.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $162.41 / $195.43 / $352.56	Professional		$162.41	$195.43	$352.56
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 $104.70 / $125.99 / $227.28	Professional	TC	$104.70	$125.99	$227.28
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $56.96 / $57.25 / $297.26	Facility	26	$56.96	$57.25	$297.26
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $157.07 / $219.69 / $338.84	Professional		$157.07	$219.69	$338.84
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $46.89 / $57.25 / $103.67	Professional	26	$46.89	$57.25	$103.67
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $103.68 / $146.90 / $220.39	Professional	TC	$103.68	$146.90	$220.39
United Facility/Professional Professional Modifier Low / Median / High Price $145.90 / $254.37 / $390.56	Professional		$145.90	$254.37	$390.56
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 $106.10 / $172.86 / $264.41	Professional	TC	$106.10	$172.86	$264.41