Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.95 / $7.95 / $9.27	Facility	26	$7.95	$7.95	$9.27
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.25 / $145.06 / $463.79	Facility	TC	$32.25	$145.06	$463.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.58 / $34.97 / $69.73	Professional		$24.58	$34.97	$69.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.83 / $6.79 / $11.05	Professional	26	$5.83	$6.79	$11.05
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.24 / $15.97 / $20.11	Professional	52	$12.24	$15.97	$20.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $27.65 / $54.79	Professional	TC	$22.57	$27.65	$54.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $50.53 / $73.12	Professional		$37.20	$50.53	$73.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.47 / $9.13 / $12.72	Professional	26	$6.47	$9.13	$12.72
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $55.80 / $75.80 / $109.68	Professional	50	$55.80	$75.80	$109.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.73 / $40.58 / $60.40	Professional	TC	$30.73	$40.58	$60.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.65 / $49.17 / $87.96	Professional		$26.65	$49.17	$87.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.12 / $10.62 / $15.56	Professional	26	$6.12	$10.62	$15.56
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $49.70 / $49.70 / $49.70	Professional	50	$49.70	$49.70	$49.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.55 / $40.47 / $72.40	Professional	TC	$19.55	$40.47	$72.40
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $47.40 / $57.04 / $102.90	Professional		$47.40	$57.04	$102.90
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $8.24 / $9.92 / $17.89	Professional	26	$8.24	$9.92	$17.89
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $39.15 / $47.12 / $85.01	Professional	TC	$39.15	$47.12	$85.01
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $7.65 / $7.95 / $35.11	Facility	26	$7.65	$7.95	$35.11
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $32.25 / $125.03 / $337.31	Facility	TC	$32.25	$125.03	$337.31
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $28.41 / $42.17 / $72.84	Professional		$28.41	$42.17	$72.84
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $6.21 / $7.95 / $13.92	Professional	26	$6.21	$7.95	$13.92
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $12.29 / $20.11 / $31.60	Professional	52	$12.29	$20.11	$31.60
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $25.30 / $36.36 / $60.41	Professional	TC	$25.30	$36.36	$60.41
United Facility/Professional Professional Modifier Low / Median / High Price $33.08 / $43.31 / $83.73	Professional		$33.08	$43.31	$83.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $9.94 / $16.55	Professional	26	$7.22	$9.94	$16.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.06 / $34.64 / $66.03	Professional	TC	$26.06	$34.64	$66.03