Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.95 / $251.62 / $410.36	Facility		$43.95	$251.62	$410.36
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.57 / $9.57 / $11.07	Facility	26	$9.57	$9.57	$11.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.57 / $32.88 / $92.04	Facility	TC	$24.57	$32.88	$92.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $30.54 / $55.42	Professional		$20.39	$30.54	$55.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $7.98 / $12.48	Professional	26	$7.03	$7.98	$12.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.52 / $47.52 / $96.04	Professional	50	$47.52	$47.52	$96.04
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.10 / $14.03 / $17.07	Professional	52	$10.10	$14.03	$17.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $21.92 / $40.29	Professional	TC	$17.89	$21.92	$40.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.92 / $100.72 / $165.31	Facility		$72.92	$100.72	$165.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.49 / $41.82 / $60.40	Professional		$30.49	$41.82	$60.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.96 / $15.26	Professional	26	$7.76	$10.96	$15.26
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.74 / $62.73 / $90.60	Professional	50	$45.74	$62.73	$90.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.64 / $30.22 / $45.13	Professional	TC	$22.64	$30.22	$45.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.48 / $42.00 / $69.30	Professional		$29.48	$42.00	$69.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $12.82 / $18.72	Professional	26	$7.58	$12.82	$18.72
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.89 / $42.89 / $42.89	Professional	50	$42.89	$42.89	$42.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.29 / $30.32 / $51.52	Professional	TC	$20.29	$30.32	$51.52
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $38.75 / $46.62 / $84.12	Professional		$38.75	$46.62	$84.12
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.89 / $11.90 / $21.47	Professional	26	$9.89	$11.90	$21.47
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $28.85 / $35.20 / $66.54	Professional	TC	$28.85	$35.20	$66.54
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $36.45 / $242.29 / $452.40	Facility		$36.45	$242.29	$452.40
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $9.57 / $9.68 / $11.07	Facility	26	$9.57	$9.68	$11.07
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $24.57 / $85.45 / $92.04	Facility	TC	$24.57	$85.45	$92.04
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $34.14 / $57.42	Professional		$24.92	$34.14	$57.42
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $9.57 / $14.97	Professional	26	$7.03	$9.57	$14.97
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $47.52 / $47.52 / $96.04	Professional	50	$47.52	$47.52	$96.04
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $10.19 / $16.42 / $25.94	Professional	52	$10.19	$16.42	$25.94
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $24.57 / $43.69	Professional	TC	$17.89	$24.57	$43.69
United Facility/Professional Professional Modifier Low / Median / High Price $30.68 / $38.83 / $71.06	Professional		$30.68	$38.83	$71.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $13.22 / $21.47	Professional	26	$8.66	$13.22	$21.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $23.21 / $51.15	Professional	TC	$19.95	$23.21	$51.15