Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.26 / $167.00 / $167.00	Facility	26	$95.26	$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 $105.42 / $140.00 / $167.00	Professional	26	$105.42	$140.00	$167.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.82 / $212.50 / $300.00	Professional	52	$125.82	$212.50	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.91 / $335.00 / $433.00	Professional	TC	$251.91	$335.00	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $256.26 / $331.63 / $479.62	Professional		$256.26	$331.63	$479.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.31 / $93.59 / $142.37	Professional	26	$72.31	$93.59	$142.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $178.85 / $237.08 / $337.26	Professional	TC	$178.85	$237.08	$337.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $314.05 / $475.38 / $943.28	Professional		$314.05	$475.38	$943.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.70 / $109.66 / $155.99	Professional	26	$69.70	$109.66	$155.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $224.39 / $354.33 / $666.86	Professional	TC	$224.39	$354.33	$666.86
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $286.07 / $335.62 / $621.00	Professional		$286.07	$335.62	$621.00
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $84.91 / $99.62 / $195.84	Professional	26	$84.91	$99.62	$195.84
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $201.15 / $242.05 / $436.66	Professional	TC	$201.15	$242.05	$436.66
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $95.26 / $95.26 / $95.26	Facility	26	$95.26	$95.26	$95.26
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $275.69 / $475.00 / $762.88	Professional		$275.69	$475.00	$762.88
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $140.00 / $170.79	Professional	26	$85.11	$140.00	$170.79
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $131.96 / $212.50 / $300.00	Professional	52	$131.96	$212.50	$300.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $199.20 / $335.00 / $439.92	Professional	TC	$199.20	$335.00	$439.92
United Facility/Professional Professional Modifier Low / Median / High Price $269.52 / $507.11 / $671.10	Professional		$269.52	$507.11	$671.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.33 / $104.68 / $184.32	Professional	26	$72.33	$104.68	$184.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $195.24 / $402.43 / $520.38	Professional	TC	$195.24	$402.43	$520.38