Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.64 / $15.64 / $15.64	Facility	26	$15.64	$15.64	$15.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $55.07 / $109.49	Professional		$46.93	$55.07	$109.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.97 / $13.45 / $20.70	Professional	26	$10.97	$13.45	$20.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.18 / $38.54 / $82.01	Professional	TC	$30.18	$38.54	$82.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.87 / $74.19 / $114.45	Professional		$58.87	$74.19	$114.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.94 / $17.82 / $24.79	Professional	26	$12.94	$17.82	$24.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $88.30 / $111.29 / $171.68	Professional	50	$88.30	$111.29	$171.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.93 / $57.10 / $89.66	Professional	TC	$45.93	$57.10	$89.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $82.46 / $138.55	Professional		$54.52	$82.46	$138.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.48 / $20.94 / $30.60	Professional	26	$15.48	$20.94	$30.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.48 / $60.35 / $107.95	Professional	TC	$42.48	$60.35	$107.95
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $90.28 / $162.85	Professional		$75.02	$90.28	$162.85
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $19.84 / $35.79	Professional	26	$16.48	$19.84	$35.79
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $58.53 / $70.43 / $127.06	Professional	TC	$58.53	$70.43	$127.06
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $63.28 / $109.49	Professional		$46.93	$63.28	$109.49
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.78 / $14.74 / $22.94	Professional	26	$12.78	$14.74	$22.94
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $34.14 / $47.64 / $89.08	Professional	TC	$34.14	$47.64	$89.08
United Facility/Professional Professional Modifier Low / Median / High Price $55.45 / $75.02 / $140.71	Professional		$55.45	$75.02	$140.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.60 / $20.39 / $34.76	Professional	26	$13.60	$20.39	$34.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.59 / $54.54 / $99.21	Professional	TC	$42.59	$54.54	$99.21