Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $15.49 / $15.49	Facility	26	$15.49	$15.49	$15.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $66.07 / $131.83	Professional		$39.81	$66.07	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.80 / $38.90	Professional	26	$10.96	$13.80	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $45.71 / $97.72	Professional	TC	$30.20	$45.71	$97.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $75.86 / $109.65	Professional		$53.70	$75.86	$109.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $17.38 / $24.55	Professional	26	$11.22	$17.38	$24.55
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $112.20 / $169.82	Professional	50	$79.43	$112.20	$169.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $58.88 / $81.28	Professional	TC	$42.66	$58.88	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $75.86 / $138.04	Professional		$54.95	$75.86	$138.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $18.62 / $32.36	Professional	26	$15.14	$18.62	$32.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $57.54 / $109.65	Professional	TC	$39.81	$57.54	$109.65
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $95.50 / $177.83	Professional		$75.86	$95.50	$177.83
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $20.42 / $38.02	Professional	26	$16.22	$20.42	$38.02
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $75.86 / $141.25	Professional	TC	$60.26	$75.86	$141.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $69.18 / $138.04	Professional		$46.77	$69.18	$138.04
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $16.60 / $38.90	Professional	26	$12.30	$16.60	$38.90
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $57.54 / $109.65	Professional	TC	$36.31	$57.54	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $77.62 / $144.54	Professional		$52.48	$77.62	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $19.50 / $35.48	Professional	26	$13.49	$19.50	$35.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $60.26 / $109.65	Professional	TC	$38.90	$60.26	$109.65