Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.14 / $62.14 / $70.79	Facility	26	$62.14	$62.14	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.27 / $220.65 / $265.38	Professional		$150.27	$220.65	$265.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.78 / $53.79 / $79.37	Professional	26	$46.78	$53.79	$79.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.10 / $166.81 / $213.39	Professional	TC	$95.10	$166.81	$213.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.57 / $184.50 / $279.89	Professional		$142.57	$184.50	$279.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.79 / $69.75 / $105.74	Professional	26	$53.79	$69.75	$105.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $88.67 / $114.75 / $174.16	Professional	TC	$88.67	$114.75	$174.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.18 / $266.24 / $435.00	Professional		$175.18	$266.24	$435.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.25 / $82.49 / $115.54	Professional	26	$52.25	$82.49	$115.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.32 / $164.83 / $341.00	Professional	TC	$108.32	$164.83	$341.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $166.94 / $195.85 / $362.39	Professional		$166.94	$195.85	$362.39
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $63.07 / $75.89 / $136.91	Professional	26	$63.07	$75.89	$136.91
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $103.87 / $125.00 / $225.48	Professional	TC	$103.87	$125.00	$225.48
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $159.69 / $226.00 / $325.54	Professional		$159.69	$226.00	$325.54
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $49.60 / $62.14 / $113.16	Professional	26	$49.60	$62.14	$113.16
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $102.87 / $148.28 / $213.39	Professional	TC	$102.87	$148.28	$213.39
United Facility/Professional Professional Modifier Low / Median / High Price $137.32 / $199.52 / $353.85	Professional		$137.32	$199.52	$353.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.67 / $78.13 / $128.24	Professional	26	$53.67	$78.13	$128.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.65 / $125.58 / $229.28	Professional	TC	$83.65	$125.58	$229.28