Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.16 / $279.08 / $503.58	Facility		$105.16	$279.08	$503.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.97 / $9.97 / $46.21	Facility	26	$9.97	$9.97	$46.21
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.42 / $108.84 / $407.97	Facility	TC	$29.42	$108.84	$407.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.80 / $39.39 / $85.52	Professional		$23.80	$39.39	$85.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.55 / $14.17	Professional	26	$7.33	$8.55	$14.17
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $55.20 / $90.30 / $114.57	Professional	50	$55.20	$90.30	$114.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $26.50 / $50.15	Professional	TC	$21.64	$26.50	$50.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.80 / $118.52 / $194.52	Facility		$85.80	$118.52	$194.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.22 / $49.30 / $71.20	Professional		$36.22	$49.30	$71.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $11.41 / $15.89	Professional	26	$8.09	$11.41	$15.89
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $54.34 / $73.95 / $106.81	Professional	50	$54.34	$73.95	$106.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.14 / $37.33 / $55.31	Professional	TC	$28.14	$37.33	$55.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.72 / $47.85 / $81.31	Professional		$33.72	$47.85	$81.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.36 / $19.52	Professional	26	$8.32	$13.36	$19.52
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $49.18 / $49.18 / $49.18	Professional	50	$49.18	$49.18	$49.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.74 / $36.94 / $62.77	Professional	TC	$23.74	$36.94	$62.77
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $473.00 / $473.00 / $473.00	Facility		$473.00	$473.00	$473.00
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $38.00 / $40.00	Professional		$38.00	$38.00	$40.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $46.17 / $56.33 / $106.49	Professional		$46.17	$56.33	$106.49
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $10.31 / $12.40 / $22.38	Professional	26	$10.31	$12.40	$22.38
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $35.86 / $43.16 / $77.84	Professional	TC	$35.86	$43.16	$77.84
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $106.28 / $290.27 / $641.84	Facility		$106.28	$290.27	$641.84
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $9.59 / $10.11 / $49.50	Facility	26	$9.59	$10.11	$49.50
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $29.42 / $117.69 / $418.30	Facility	TC	$29.42	$117.69	$418.30
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $28.96 / $44.15 / $78.97	Professional		$28.96	$44.15	$78.97
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $9.97 / $18.39	Professional	26	$7.78	$9.97	$18.39
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $55.20 / $90.30 / $114.57	Professional	50	$55.20	$90.30	$114.57
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $24.25 / $33.25 / $55.30	Professional	TC	$24.25	$33.25	$55.30
United Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $43.17 / $82.61	Professional		$35.36	$43.17	$82.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.67 / $12.50 / $22.19	Professional	26	$8.67	$12.50	$22.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.89 / $31.52 / $61.25	Professional	TC	$23.89	$31.52	$61.25