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 / $475.00 / $699.55	Professional		$425.00	$475.00	$699.55
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 $297.50 / $335.00 / $543.97	Professional	TC	$297.50	$335.00	$543.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $430.22 / $563.69 / $808.59	Professional		$430.22	$563.69	$808.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $98.76 / $137.69 / $210.79	Professional	26	$98.76	$137.69	$210.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $314.63 / $425.28 / $597.79	Professional	TC	$314.63	$425.28	$597.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $536.12 / $827.36 / $1,251.86	Professional		$536.12	$827.36	$1,251.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.63 / $161.50 / $228.79	Professional	26	$102.63	$161.50	$228.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $403.36 / $594.12 / $1,123.59	Professional	TC	$403.36	$594.12	$1,123.59
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $482.27 / $580.35 / $1,046.91	Professional		$482.27	$580.35	$1,046.91
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 $356.55 / $429.06 / $774.00	Professional	TC	$356.55	$429.06	$774.00
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 $427.80 / $600.00 / $1,036.57	Professional		$427.80	$600.00	$1,036.57
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $112.95 / $157.90 / $250.85	Professional	26	$112.95	$157.90	$250.85
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $323.39 / $433.00 / $785.71	Professional	TC	$323.39	$433.00	$785.71
United Facility/Professional Professional Modifier Low / Median / High Price $423.74 / $635.29 / $1,141.58	Professional		$423.74	$635.29	$1,141.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.67 / $153.74 / $253.37	Professional	26	$108.67	$153.74	$253.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $317.73 / $489.09 / $871.00	Professional	TC	$317.73	$489.09	$871.00