Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $257.04 / $645.65	Facility		$120.23	$257.04	$645.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $10.96 / $53.70	Facility	26	$9.55	$10.96	$53.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.88 / $131.83 / $338.84	Facility	TC	$33.88	$131.83	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $51.29 / $114.82	Professional		$14.13	$51.29	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.00 / $29.51	Professional	26	$7.08	$10.00	$29.51
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.78 / $131.83 / $218.78	Professional	50	$17.78	$131.83	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $43.65 / $85.11	Professional	TC	$25.12	$43.65	$85.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $134.90 / $134.90	Facility		$107.15	$134.90	$134.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $53.70 / $75.86	Professional		$35.48	$53.70	$75.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.72 / $15.85	Professional	26	$6.76	$10.72	$15.85
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $77.62 / $117.49	Professional	50	$52.48	$77.62	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $40.74 / $57.54	Professional	TC	$28.18	$40.74	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $52.48 / $93.33	Professional		$30.90	$52.48	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.02 / $20.89	Professional	26	$8.32	$12.02	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $40.74 / $75.86	Professional	TC	$22.91	$40.74	$75.86
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Facility		$269.15	$269.15	$269.15
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $38.02	Professional		$28.84	$28.84	$38.02
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $123.03	Professional		$51.29	$64.57	$123.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.18 / $24.55	Professional	26	$10.47	$13.18	$24.55
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $51.29 / $97.72	Professional	TC	$40.74	$51.29	$97.72
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $263.03 / $645.65	Facility		$89.13	$263.03	$645.65
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $10.96 / $53.70	Facility	26	$9.55	$10.96	$53.70
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $33.88 / $131.83 / $354.81	Facility	TC	$33.88	$131.83	$354.81
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $50.12 / $102.33	Professional		$20.89	$50.12	$102.33
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.48 / $26.30	Professional	26	$7.94	$11.48	$26.30
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $128.82 / $218.78	Professional	50	$46.77	$128.82	$218.78
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $41.69 / $81.28	Professional	TC	$28.18	$41.69	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $52.48 / $100.00	Professional		$36.31	$52.48	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.59 / $22.39	Professional	26	$8.71	$12.59	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $42.66 / $74.13	Professional	TC	$27.54	$42.66	$74.13