Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.65 / $167.00 / $167.00	Facility	26	$96.65	$167.00	$167.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.26 / $475.00 / $600.00	Professional		$313.26	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.03 / $140.00 / $167.00	Professional	26	$107.03	$140.00	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.95 / $335.00 / $433.00	Professional	TC	$191.95	$335.00	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.08 / $273.17 / $401.53	Professional		$211.08	$273.17	$401.53
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 $135.30 / $177.69 / $257.08	Professional	TC	$135.30	$177.69	$257.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.00 / $393.60 / $913.88	Professional		$258.00	$393.60	$913.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.47 / $112.82 / $157.52	Professional	26	$75.47	$112.82	$157.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.03 / $264.74 / $670.65	Professional	TC	$167.03	$264.74	$670.65
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $239.49 / $288.19 / $519.88	Professional		$239.49	$288.19	$519.88
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 $153.34 / $184.52 / $332.87	Professional	TC	$153.34	$184.52	$332.87
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $96.65 / $96.65 / $96.65	Facility	26	$96.65	$96.65	$96.65
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $236.22 / $475.00 / $642.44	Professional		$236.22	$475.00	$642.44
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $86.35 / $140.00 / $175.42	Professional	26	$86.35	$140.00	$175.42
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $151.74 / $324.81 / $433.00	Professional	TC	$151.74	$324.81	$433.00
United Facility/Professional Professional Modifier Low / Median / High Price $204.66 / $315.64 / $588.36	Professional		$204.66	$315.64	$588.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.15 / $106.05 / $175.36	Professional	26	$76.15	$106.05	$175.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.36 / $199.60 / $359.85	Professional	TC	$144.36	$199.60	$359.85