Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $15.14 / $478.63	Facility	26	$12.59	$15.14	$478.63
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $45.71 / $158.49 / $537.03	Facility	TC	$45.71	$158.49	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $57.54 / $128.82	Professional		$30.20	$57.54	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.45 / $40.74	Professional	26	$10.00	$14.45	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $61.66 / $109.65 / $263.03	Professional	50	$61.66	$109.65	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $48.98 / $100.00	Professional	TC	$28.18	$48.98	$100.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $61.66 / $85.11	Professional		$39.81	$61.66	$85.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.13 / $20.89	Professional	26	$8.71	$14.13	$20.89
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $58.88 / $89.13 / $134.90	Professional	50	$58.88	$89.13	$134.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $45.71 / $63.10	Professional	TC	$30.90	$45.71	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $58.88 / $107.15	Professional		$36.31	$58.88	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.85 / $26.92	Professional	26	$10.23	$15.85	$26.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $43.65 / $83.18	Professional	TC	$26.30	$43.65	$83.18
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $41.69 / $52.48	Professional		$38.90	$41.69	$52.48
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $74.13 / $147.91	Professional		$60.26	$74.13	$147.91
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $16.60 / $31.62	Professional	26	$13.18	$16.60	$31.62
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $58.88 / $114.82	Professional	TC	$46.77	$58.88	$114.82
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $15.14 / $478.63	Facility	26	$12.59	$15.14	$478.63
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $42.66 / $151.36 / $537.03	Facility	TC	$42.66	$151.36	$537.03
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $58.88 / $123.03	Professional		$30.90	$58.88	$123.03
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.49 / $36.31	Professional	26	$10.23	$15.49	$36.31
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $61.66 / $114.82 / $263.03	Professional	50	$61.66	$114.82	$263.03
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $46.77 / $89.13	Professional	TC	$30.90	$46.77	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $61.66 / $112.20	Professional		$40.74	$61.66	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $16.22 / $28.18	Professional	26	$11.22	$16.22	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $45.71 / $83.18	Professional	TC	$29.51	$45.71	$83.18