Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.85 / $16.85 / $16.85	Facility	26	$16.85	$16.85	$16.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $41.97 / $150.24 / $158.01	Facility	TC	$41.97	$150.24	$158.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $52.94 / $91.23	Professional		$44.27	$52.94	$91.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.41 / $15.24 / $24.29	Professional	26	$13.41	$15.24	$24.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $36.45 / $69.26	Professional	TC	$30.85	$36.45	$69.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.40 / $69.28 / $103.01	Professional		$52.40	$69.28	$103.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.59 / $19.18 / $26.70	Professional	26	$13.59	$19.18	$26.70
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $78.59 / $103.92 / $154.52	Professional	50	$78.59	$103.92	$154.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.82 / $49.05 / $76.31	Professional	TC	$38.82	$49.05	$76.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.71 / $71.34 / $119.60	Professional		$55.71	$71.34	$119.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.26 / $22.57 / $32.97	Professional	26	$16.26	$22.57	$32.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.44 / $51.96 / $88.28	Professional	TC	$35.44	$51.96	$88.28
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $66.78 / $81.47 / $154.03	Professional		$66.78	$81.47	$154.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $17.30 / $20.83 / $37.58	Professional	26	$17.30	$20.83	$37.58
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $49.46 / $58.03 / $114.08	Professional	TC	$49.46	$58.03	$114.08
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $146.69 / $150.24 / $162.56	Facility	TC	$146.69	$150.24	$162.56
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $62.58 / $107.83	Professional		$44.27	$62.58	$107.83
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $13.41 / $16.85 / $31.06	Professional	26	$13.41	$16.85	$31.06
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $46.17 / $76.38	Professional	TC	$30.85	$46.17	$76.38
United Facility/Professional Professional Modifier Low / Median / High Price $52.69 / $72.93 / $130.80	Professional		$52.69	$72.93	$130.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.16 / $23.67 / $35.07	Professional	26	$15.16	$23.67	$35.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.06 / $45.04 / $87.41	Professional	TC	$34.06	$45.04	$87.41