Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.17 / $167.00 / $167.00	Facility	26	$97.17	$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 / $335.00 / $433.00	Professional	TC	$259.35	$335.00	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $300.73 / $389.19 / $568.78	Professional		$300.73	$389.19	$568.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.59 / $114.65 / $174.85	Professional	26	$88.59	$114.65	$174.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $208.49 / $274.52 / $393.93	Professional	TC	$208.49	$274.52	$393.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $368.60 / $565.48 / $943.28	Professional		$368.60	$565.48	$943.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.57 / $135.38 / $189.34	Professional	26	$85.57	$135.38	$189.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $258.64 / $383.52 / $776.00	Professional	TC	$258.64	$383.52	$776.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $339.24 / $413.87 / $782.46	Professional		$339.24	$413.87	$782.46
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $104.29 / $125.50 / $226.39	Professional	26	$104.29	$125.50	$226.39
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $234.95 / $282.73 / $510.03	Professional	TC	$234.95	$282.73	$510.03
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $97.17 / $97.17 / $167.00	Facility	26	$97.17	$97.17	$167.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $326.24 / $494.18 / $711.52	Professional		$326.24	$494.18	$711.52
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $93.70 / $145.76 / $186.62	Professional	26	$93.70	$145.76	$186.62
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $232.54 / $358.03 / $433.00	Professional	TC	$232.54	$358.03	$433.00
United Facility/Professional Professional Modifier Low / Median / High Price $291.83 / $441.59 / $783.28	Professional		$291.83	$441.59	$783.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.06 / $128.01 / $224.72	Professional	26	$88.06	$128.01	$224.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $224.11 / $327.63 / $558.55	Professional	TC	$224.11	$327.63	$558.55