Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.56 / $167.00 / $193.36	Facility	26	$73.56	$167.00	$193.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $325.72 / $475.00 / $600.00	Professional		$325.72	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.32 / $140.00 / $167.00	Professional	26	$90.32	$140.00	$167.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $110.86 / $212.50 / $300.00	Professional	52	$110.86	$212.50	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $240.23 / $335.00 / $433.00	Professional	TC	$240.23	$335.00	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.78 / $289.60 / $428.48	Professional		$223.78	$289.60	$428.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.45 / $87.30 / $132.00	Professional	26	$67.45	$87.30	$132.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $335.68 / $434.41 / $642.72	Professional	50	$335.68	$434.41	$642.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $155.29 / $201.44 / $296.48	Professional	TC	$155.29	$201.44	$296.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.77 / $418.17 / $875.04	Professional		$272.77	$418.17	$875.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.39 / $102.30 / $145.30	Professional	26	$64.39	$102.30	$145.30
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $343.71 / $343.71 / $343.71	Professional	50	$343.71	$343.71	$343.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.93 / $299.33 / $647.00	Professional	TC	$188.93	$299.33	$647.00
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $311.00 / $311.00 / $311.00	Professional		$311.00	$311.00	$311.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $255.56 / $307.52 / $554.77	Professional		$255.56	$307.52	$554.77
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $78.73 / $94.74 / $170.91	Professional	26	$78.73	$94.74	$170.91
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $176.83 / $212.80 / $383.86	Professional	TC	$176.83	$212.80	$383.86
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $69.20 / $89.55 / $193.36	Facility	26	$69.20	$89.55	$193.36
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $246.19 / $475.00 / $600.00	Professional		$246.19	$475.00	$600.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $77.59 / $140.00 / $167.00	Professional	26	$77.59	$140.00	$167.00
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $117.81 / $212.50 / $300.00	Professional	52	$117.81	$212.50	$300.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $174.86 / $335.00 / $433.00	Professional	TC	$174.86	$335.00	$433.00
United Facility/Professional Professional Modifier Low / Median / High Price $215.97 / $320.77 / $579.27	Professional		$215.97	$320.77	$579.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.43 / $107.10 / $161.88	Professional	26	$69.43	$107.10	$161.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.26 / $228.38 / $406.39	Professional	TC	$148.26	$228.38	$406.39