Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.00 / $167.00 / $167.00	Facility	26	$167.00	$167.00	$167.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $600.00	Professional		$370.50	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $140.00 / $167.00	Professional	26	$111.15	$140.00	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $338.66 / $433.00	Professional	TC	$259.35	$338.66	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $303.45 / $396.50 / $579.14	Professional		$303.45	$396.50	$579.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.29 / $114.75 / $175.54	Professional	26	$82.29	$114.75	$175.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $210.97 / $281.38 / $403.60	Professional	TC	$210.97	$281.38	$403.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $374.31 / $569.83 / $943.28	Professional		$374.31	$569.83	$943.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.76 / $135.91 / $190.10	Professional	26	$90.76	$135.91	$190.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $264.33 / $381.84 / $776.00	Professional	TC	$264.33	$381.84	$776.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $345.42 / $415.66 / $749.84	Professional		$345.42	$415.66	$749.84
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $104.70 / $125.99 / $227.28	Professional	26	$104.70	$125.99	$227.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $240.72 / $289.68 / $522.55	Professional	TC	$240.72	$289.68	$522.55
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $332.37 / $530.65 / $1,016.00	Professional		$332.37	$530.65	$1,016.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $94.10 / $154.00 / $208.86	Professional	26	$94.10	$154.00	$208.86
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $238.26 / $372.09 / $511.22	Professional	TC	$238.26	$372.09	$511.22
United Facility/Professional Professional Modifier Low / Median / High Price $320.48 / $532.63 / $745.24	Professional		$320.48	$532.63	$745.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.39 / $128.01 / $211.26	Professional	26	$88.39	$128.01	$211.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $228.81 / $333.21 / $570.26	Professional	TC	$228.81	$333.21	$570.26