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 / $145.65 / $187.20	Professional	26	$111.15	$145.65	$187.20
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 $355.81 / $460.46 / $674.51	Professional		$355.81	$460.46	$674.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.01 / $146.25 / $224.61	Professional	26	$113.01	$146.25	$224.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $238.11 / $313.36 / $449.91	Professional	TC	$238.11	$313.36	$449.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $437.60 / $663.72 / $1,267.63	Professional		$437.60	$663.72	$1,267.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.65 / $176.81 / $243.04	Professional	26	$117.65	$176.81	$243.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $296.55 / $425.73 / $1,120.83	Professional	TC	$296.55	$425.73	$1,120.83
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $402.31 / $484.12 / $873.33	Professional		$402.31	$484.12	$873.33
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $133.97 / $161.21 / $290.82	Professional	26	$133.97	$161.21	$290.82
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $268.33 / $327.37 / $618.92	Professional	TC	$268.33	$327.37	$618.92
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $385.99 / $546.25 / $852.31	Professional		$385.99	$546.25	$852.31
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $120.31 / $167.00 / $264.06	Professional	26	$120.31	$167.00	$264.06
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $253.95 / $382.96 / $576.54	Professional	TC	$253.95	$382.96	$576.54
United Facility/Professional Professional Modifier Low / Median / High Price $373.23 / $570.55 / $929.34	Professional		$373.23	$570.55	$929.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.29 / $163.72 / $288.86	Professional	26	$117.29	$163.72	$288.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $256.95 / $389.89 / $640.48	Professional	TC	$256.95	$389.89	$640.48