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 $306.74 / $475.00 / $600.00	Professional		$306.74	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.89 / $140.00 / $167.00	Professional	26	$96.89	$140.00	$167.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $104.29 / $212.50 / $300.00	Professional	52	$104.29	$212.50	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $176.17 / $335.00 / $433.00	Professional	TC	$176.17	$335.00	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.79 / $274.08 / $402.22	Professional		$211.79	$274.08	$402.22
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 $136.02 / $178.14 / $257.77	Professional	TC	$136.02	$178.14	$257.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.41 / $394.25 / $903.50	Professional		$258.41	$394.25	$903.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.81 / $112.82 / $158.28	Professional	26	$70.81	$112.82	$158.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.43 / $265.39 / $669.49	Professional	TC	$167.43	$265.39	$669.49
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $229.00 / $229.00 / $229.00	Professional		$229.00	$229.00	$229.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $239.90 / $288.69 / $520.77	Professional		$239.90	$288.69	$520.77
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 $153.75 / $185.02 / $333.76	Professional	TC	$153.75	$185.02	$333.76
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $80.43 / $97.93 / $438.47	Facility	26	$80.43	$97.93	$438.47
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $229.79 / $475.00 / $649.00	Professional		$229.79	$475.00	$649.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $80.43 / $140.00 / $176.25	Professional	26	$80.43	$140.00	$176.25
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $110.51 / $212.50 / $300.00	Professional	52	$110.51	$212.50	$300.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $148.49 / $322.47 / $433.00	Professional	TC	$148.49	$322.47	$433.00
United Facility/Professional Professional Modifier Low / Median / High Price $220.10 / $309.22 / $548.04	Professional		$220.10	$309.22	$548.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.15 / $117.02 / $175.18	Professional	26	$76.15	$117.02	$175.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.61 / $198.16 / $360.78	Professional	TC	$131.61	$198.16	$360.78