Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.77 / $167.00 / $167.00	Facility	26	$140.77	$167.00	$167.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $494.18 / $745.15	Professional		$425.00	$494.18	$745.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $142.62 / $167.00	Professional	26	$111.15	$142.62	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $297.50 / $349.37 / $589.57	Professional	TC	$297.50	$349.37	$589.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $460.99 / $596.58 / $859.04	Professional		$460.99	$596.58	$859.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.06 / $137.25 / $210.79	Professional	26	$106.06	$137.25	$210.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $343.79 / $458.17 / $648.25	Professional	TC	$343.79	$458.17	$648.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $567.70 / $808.83 / $1,254.30	Professional		$567.70	$808.83	$1,254.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.99 / $161.50 / $228.79	Professional	26	$102.99	$161.50	$228.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $435.34 / $640.05 / $1,093.77	Professional	TC	$435.34	$640.05	$1,093.77
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $512.36 / $616.55 / $1,112.23	Professional		$512.36	$616.55	$1,112.23
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $125.72 / $151.29 / $272.91	Professional	26	$125.72	$151.29	$272.91
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $386.64 / $465.27 / $839.32	Professional	TC	$386.64	$465.27	$839.32
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $140.77 / $140.77 / $140.77	Facility	26	$140.77	$140.77	$140.77
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $600.00 / $1,016.00	Professional		$475.00	$600.00	$1,016.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $123.62 / $165.99 / $250.85	Professional	26	$123.62	$165.99	$250.85
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $433.00 / $850.12	Professional	TC	$335.00	$433.00	$850.12
United Facility/Professional Professional Modifier Low / Median / High Price $448.61 / $746.77 / $1,209.72	Professional		$448.61	$746.77	$1,209.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.67 / $153.74 / $270.58	Professional	26	$108.67	$153.74	$270.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $342.60 / $524.29 / $939.13	Professional	TC	$342.60	$524.29	$939.13