Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $234.42 / $512.86	Facility		$81.28	$234.42	$512.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $10.00 / $11.48	Facility	26	$9.55	$10.00	$11.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.62 / $102.33 / $407.38	Facility	TC	$31.62	$102.33	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $38.90 / $85.11	Professional		$15.85	$38.90	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.72 / $32.36	Professional	26	$7.08	$10.72	$32.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $70.79 / $199.53	Professional	50	$46.77	$70.79	$199.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.11 / $33.11 / $33.11	Professional	52	$33.11	$33.11	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $29.51 / $69.18	Professional	TC	$17.78	$29.51	$69.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $104.71 / $104.71	Facility		$83.18	$104.71	$104.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $43.65 / $64.57	Professional		$29.51	$43.65	$64.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.47 / $15.14	Professional	26	$6.61	$10.47	$15.14
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $66.07 / $97.72	Professional	50	$43.65	$66.07	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.11 / $47.86	Professional	TC	$22.91	$33.11	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $43.65 / $77.62	Professional		$27.54	$43.65	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.02 / $19.95	Professional	26	$8.32	$12.02	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $33.11 / $58.88	Professional	TC	$19.05	$33.11	$58.88
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $52.48 / $97.72	Professional		$38.02	$52.48	$97.72
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $12.30 / $22.91	Professional	26	$9.77	$12.30	$22.91
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $39.81 / $79.43	Professional	TC	$31.62	$39.81	$79.43
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $245.47 / $489.78	Facility		$50.12	$245.47	$489.78
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $10.00 / $11.48	Facility	26	$9.55	$10.00	$11.48
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $31.62 / $102.33 / $407.38	Facility	TC	$31.62	$102.33	$407.38
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $40.74 / $85.11	Professional		$18.62	$40.74	$85.11
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.48 / $26.30	Professional	26	$7.94	$11.48	$26.30
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $85.11 / $204.17	Professional	50	$50.12	$85.11	$204.17
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $28.18 / $28.18 / $52.48	Professional	52	$28.18	$28.18	$52.48
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $67.61	Professional	TC	$21.88	$33.11	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $45.71 / $87.10	Professional		$30.90	$45.71	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.02 / $21.38	Professional	26	$8.32	$12.02	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.11 / $57.54	Professional	TC	$22.91	$33.11	$57.54