Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.97 / $57.25 / $64.84	Facility	26	$53.97	$57.25	$64.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.31 / $221.44 / $278.39	Professional		$160.31	$221.44	$278.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $50.67 / $71.86	Professional	26	$43.82	$50.67	$71.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.06 / $177.61 / $217.98	Professional	TC	$117.06	$177.61	$217.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.21 / $218.34 / $337.95	Professional		$158.21	$218.34	$337.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.70 / $64.34 / $96.75	Professional	26	$49.70	$64.34	$96.75
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $237.32 / $327.51 / $506.92	Professional	50	$237.32	$327.51	$506.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $108.49 / $144.16 / $241.19	Professional	TC	$108.49	$144.16	$241.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.94 / $293.99 / $477.86	Professional		$215.94	$293.99	$477.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.92 / $75.98 / $106.37	Professional	26	$50.92	$75.98	$106.37
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $264.19 / $264.19 / $264.19	Professional	50	$264.19	$264.19	$264.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.38 / $222.94 / $346.07	Professional	TC	$154.38	$222.94	$346.07
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $201.57 / $233.22 / $437.57	Professional		$201.57	$233.22	$437.57
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $57.71 / $67.70 / $125.28	Professional	26	$57.71	$67.70	$125.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $143.86 / $173.11 / $312.29	Professional	TC	$143.86	$173.11	$312.29
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $53.97 / $57.25 / $64.84	Facility	26	$53.97	$57.25	$64.84
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $182.93 / $230.80 / $360.68	Professional		$182.93	$230.80	$360.68
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $46.61 / $57.25 / $103.67	Professional	26	$46.61	$57.25	$103.67
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $126.93 / $179.43 / $243.94	Professional	TC	$126.93	$179.43	$243.94
United Facility/Professional Professional Modifier Low / Median / High Price $181.08 / $245.92 / $422.20	Professional		$181.08	$245.92	$422.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.66 / $71.55 / $118.12	Professional	26	$50.66	$71.55	$118.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $130.28 / $182.83 / $324.75	Professional	TC	$130.28	$182.83	$324.75