Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.00 / $167.00 / $167.00	Facility	26	$167.00	$167.00	$167.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $600.00	Professional		$370.50	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $140.00 / $167.00	Professional	26	$111.15	$140.00	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $267.33 / $335.00 / $450.05	Professional	TC	$267.33	$335.00	$450.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.95 / $455.42 / $653.09	Professional		$346.95	$455.42	$653.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.87 / $104.40 / $158.26	Professional	26	$74.87	$104.40	$158.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.33 / $349.91 / $494.83	Professional	TC	$260.33	$349.91	$494.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $433.35 / $615.42 / $943.28	Professional		$433.35	$615.42	$943.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.63 / $122.43 / $174.06	Professional	26	$77.63	$122.43	$174.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $333.24 / $488.80 / $730.00	Professional	TC	$333.24	$488.80	$730.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $389.53 / $468.74 / $845.59	Professional		$389.53	$468.74	$845.59
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $94.39 / $113.59 / $204.90	Professional	26	$94.39	$113.59	$204.90
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $295.14 / $355.15 / $640.69	Professional	TC	$295.14	$355.15	$640.69
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $377.47 / $546.25 / $843.38	Professional		$377.47	$546.25	$843.38
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $86.03 / $143.38 / $189.55	Professional	26	$86.03	$143.38	$189.55
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $292.26 / $414.06 / $645.74	Professional	TC	$292.26	$414.06	$645.74
United Facility/Professional Professional Modifier Low / Median / High Price $342.21 / $511.94 / $864.15	Professional		$342.21	$511.94	$864.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.73 / $116.18 / $192.75	Professional	26	$83.73	$116.18	$192.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $287.63 / $420.91 / $671.40	Professional	TC	$287.63	$420.91	$671.40