Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $371.54 / $1,258.93	Facility		$50.12	$371.54	$1,258.93
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $13.49 / $14.79	Facility	26	$12.88	$13.49	$14.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $43.65 / $120.23 / $707.95	Facility	TC	$43.65	$120.23	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $44.67 / $77.62	Professional		$33.11	$44.67	$77.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $29.51	Professional	26	$8.91	$12.02	$29.51
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $38.02 / $38.02	Professional	50	$38.02	$38.02	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $32.36 / $56.23	Professional	TC	$22.91	$32.36	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $52.48 / $77.62	Professional		$37.15	$52.48	$77.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.80 / $20.42	Professional	26	$9.33	$13.80	$20.42
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $56.23 / $77.62 / $117.49	Professional	50	$56.23	$77.62	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.02 / $57.54	Professional	TC	$28.18	$38.02	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $53.70 / $93.33	Professional		$39.81	$53.70	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $26.92	Professional	26	$12.02	$15.14	$26.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $38.90 / $70.79	Professional	TC	$27.54	$38.90	$70.79
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $63.10 / $120.23	Professional		$48.98	$63.10	$120.23
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.22 / $30.90	Professional	26	$12.88	$16.22	$30.90
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $47.86 / $89.13	Professional	TC	$38.02	$47.86	$89.13
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $371.54 / $630.96	Facility		$50.12	$371.54	$630.96
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $13.49 / $14.79	Facility	26	$12.88	$13.49	$14.79
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $43.65 / $120.23 / $707.95	Facility	TC	$43.65	$120.23	$707.95
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $50.12 / $93.33	Professional		$38.02	$50.12	$93.33
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.49 / $27.54	Professional	26	$10.00	$13.49	$27.54
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $38.02 / $177.83	Professional	50	$38.02	$38.02	$177.83
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $37.15 / $69.18	Professional	TC	$26.92	$37.15	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $54.95 / $107.15	Professional		$37.15	$54.95	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $16.22 / $29.51	Professional	26	$11.22	$16.22	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $38.90 / $74.13	Professional	TC	$26.30	$38.90	$74.13