Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $97.72 / $489.78	Facility	26	$81.28	$97.72	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $478.63 / $977.24	Professional		$234.42	$478.63	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $120.23 / $239.88	Professional	26	$67.61	$120.23	$239.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $158.49 / $158.49 / $870.96	Professional	52	$158.49	$158.49	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $190.55 / $588.84	Professional	TC	$93.33	$190.55	$588.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $281.84 / $707.95	Professional		$190.55	$281.84	$707.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $100.00 / $229.09	Professional	26	$67.61	$100.00	$229.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $177.83 / $457.09	Professional	TC	$123.03	$177.83	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $512.86 / $933.25	Professional		$257.04	$512.86	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $199.53	Professional	26	$72.44	$104.71	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $354.81 / $691.83	Professional	TC	$147.91	$354.81	$691.83
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $288.40 / $549.54	Professional		$229.09	$288.40	$549.54
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $104.71 / $194.98	Professional	26	$83.18	$104.71	$194.98
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $190.55 / $371.54	Professional	TC	$147.91	$190.55	$371.54
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $97.72 / $489.78	Facility	26	$81.28	$97.72	$489.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $426.58 / $912.01	Professional		$239.88	$426.58	$912.01
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $128.82 / $234.42	Professional	26	$72.44	$128.82	$234.42
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $870.96 / $870.96 / $870.96	Professional	52	$870.96	$870.96	$870.96
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $263.03 / $616.60	Professional	TC	$147.91	$263.03	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $316.23 / $676.08	Professional		$204.17	$316.23	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $107.15 / $190.55	Professional	26	$74.13	$107.15	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $204.17 / $446.68	Professional	TC	$131.83	$204.17	$446.68