Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.78 / $225.06 / $463.85	Facility		$55.78	$225.06	$463.85
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.80 / $12.80 / $42.95	Facility	26	$12.80	$12.80	$42.95
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.34 / $138.97 / $559.88	Facility	TC	$38.34	$138.97	$559.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.72 / $46.08 / $80.73	Professional		$32.72	$46.08	$80.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $11.37 / $18.14	Professional	26	$10.02	$11.37	$18.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.08 / $46.08 / $46.08	Professional	50	$46.08	$46.08	$46.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.55 / $33.95 / $64.06	Professional	TC	$27.55	$33.95	$64.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.26 / $59.45 / $90.92	Professional		$46.26	$59.45	$90.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $14.39 / $20.34	Professional	26	$10.35	$14.39	$20.34
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $69.39 / $89.18 / $136.38	Professional	50	$69.39	$89.18	$136.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.90 / $44.95 / $70.58	Professional	TC	$35.90	$44.95	$70.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.61 / $65.31 / $110.10	Professional		$43.61	$65.31	$110.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.11 / $16.91 / $25.06	Professional	26	$12.11	$16.91	$25.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.47 / $48.21 / $85.04	Professional	TC	$33.47	$48.21	$85.04
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $431.00 / $431.00 / $431.00	Facility		$431.00	$431.00	$431.00
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $46.00 / $52.00	Professional		$35.00	$46.00	$52.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $58.94 / $70.93 / $127.95	Professional		$58.94	$70.93	$127.95
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $15.88 / $28.63	Professional	26	$13.19	$15.88	$28.63
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $45.75 / $55.82 / $105.52	Professional	TC	$45.75	$55.82	$105.52
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $64.01 / $226.50 / $501.28	Facility		$64.01	$226.50	$501.28
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.32 / $12.97 / $45.68	Facility	26	$12.32	$12.97	$45.68
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $38.34 / $138.97 / $592.91	Facility	TC	$38.34	$138.97	$592.91
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $37.60 / $55.26 / $91.27	Professional		$37.60	$55.26	$91.27
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.80 / $22.45	Professional	26	$10.47	$12.80	$22.45
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $46.08 / $46.08 / $46.08	Professional	50	$46.08	$46.08	$46.08
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $29.60 / $42.71 / $70.62	Professional	TC	$29.60	$42.71	$70.62
United Facility/Professional Professional Modifier Low / Median / High Price $44.28 / $55.94 / $106.46	Professional		$44.28	$55.94	$106.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $16.04 / $26.65	Professional	26	$11.55	$16.04	$26.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.28 / $40.11 / $81.63	Professional	TC	$34.28	$40.11	$81.63