Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.43 / $167.00 / $167.00	Facility	26	$80.43	$167.00	$167.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $305.70 / $475.00 / $600.00	Professional		$305.70	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.79 / $140.00 / $167.00	Professional	26	$97.79	$140.00	$167.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $103.94 / $212.50 / $300.00	Professional	52	$103.94	$212.50	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $175.23 / $335.00 / $433.00	Professional	TC	$175.23	$335.00	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.43 / $273.62 / $400.84	Professional		$211.43	$273.62	$400.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.72 / $95.40 / $144.44	Professional	26	$73.72	$95.40	$144.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $135.66 / $177.69 / $256.39	Professional	TC	$135.66	$177.69	$256.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.00 / $393.60 / $872.38	Professional		$258.00	$393.60	$872.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.47 / $112.82 / $158.28	Professional	26	$75.47	$112.82	$158.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.03 / $264.74 / $647.00	Professional	TC	$167.03	$264.74	$647.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $239.08 / $286.44 / $518.99	Professional		$239.08	$286.44	$518.99
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $86.15 / $103.67 / $187.01	Professional	26	$86.15	$103.67	$187.01
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $152.93 / $184.02 / $331.98	Professional	TC	$152.93	$184.02	$331.98
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $80.43 / $97.93 / $490.35	Facility	26	$80.43	$97.93	$490.35
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $231.06 / $475.00 / $655.50	Professional		$231.06	$475.00	$655.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $84.87 / $140.00 / $176.25	Professional	26	$84.87	$140.00	$176.25
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $110.13 / $212.50 / $300.00	Professional	52	$110.13	$212.50	$300.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $151.34 / $324.81 / $433.00	Professional	TC	$151.34	$324.81	$433.00
United Facility/Professional Professional Modifier Low / Median / High Price $220.51 / $317.02 / $540.34	Professional		$220.51	$317.02	$540.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.38 / $106.05 / $187.01	Professional	26	$73.38	$106.05	$187.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.36 / $211.73 / $359.85	Professional	TC	$144.36	$211.73	$359.85