Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $275.42 / $691.83	Facility		$85.11	$275.42	$691.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $11.22 / $56.23	Facility	26	$10.47	$11.22	$56.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $104.71 / $416.87	Facility	TC	$30.20	$104.71	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $42.66 / $97.72	Professional		$16.98	$42.66	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.72 / $32.36	Professional	26	$7.94	$10.72	$32.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $83.18 / $208.93	Professional	50	$52.48	$83.18	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $34.67 / $77.62	Professional	TC	$19.95	$34.67	$77.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $109.65 / $109.65	Facility		$89.13	$109.65	$109.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $44.67 / $64.57	Professional		$29.51	$44.67	$64.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $11.75 / $16.98	Professional	26	$7.41	$11.75	$16.98
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $44.67 / $64.57 / $97.72	Professional	50	$44.67	$64.57	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $31.62 / $45.71	Professional	TC	$22.39	$31.62	$45.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $45.71 / $79.43	Professional		$29.51	$45.71	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.18 / $22.39	Professional	26	$8.71	$13.18	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.11 / $58.88	Professional	TC	$20.89	$33.11	$58.88
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Facility		$512.86	$512.86	$512.86
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $43.65	Professional		$28.84	$28.84	$43.65
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $56.23 / $107.15	Professional		$43.65	$56.23	$107.15
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.80 / $25.70	Professional	26	$10.96	$13.80	$25.70
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $41.69 / $81.28	Professional	TC	$32.36	$41.69	$81.28
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $281.84 / $691.83	Facility		$85.11	$281.84	$691.83
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $10.72 / $56.23	Facility	26	$10.47	$10.72	$56.23
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $26.30 / $104.71 / $436.52	Facility	TC	$26.30	$104.71	$436.52
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $41.69 / $87.10	Professional		$16.60	$41.69	$87.10
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.02 / $28.84	Professional	26	$8.71	$12.02	$28.84
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $60.26 / $93.33 / $218.78	Professional	50	$60.26	$93.33	$218.78
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $70.79	Professional	TC	$21.88	$33.11	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $85.11	Professional		$30.90	$44.67	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.49 / $23.99	Professional	26	$9.33	$13.49	$23.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $32.36 / $58.88	Professional	TC	$22.39	$32.36	$58.88