Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.61 / $312.73 / $606.67	Facility		$92.61	$312.73	$606.67
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.16 / $9.16 / $10.74	Facility	26	$9.16	$9.16	$10.74
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.37 / $87.90 / $303.02	Facility	TC	$25.37	$87.90	$303.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.16 / $30.49 / $56.68	Professional		$22.16	$30.49	$56.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.32 / $13.82	Professional	26	$7.33	$8.32	$13.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $21.53 / $41.46	Professional	TC	$17.57	$21.53	$41.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $71.48 / $98.75 / $162.07	Facility		$71.48	$98.75	$162.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $41.82 / $60.40	Professional		$30.73	$41.82	$60.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $10.50 / $14.63	Professional	26	$7.44	$10.50	$14.63
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $46.09 / $62.73 / $90.60	Professional	50	$46.09	$62.73	$90.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.29 / $31.09 / $45.78	Professional	TC	$23.29	$31.09	$45.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.84 / $43.44 / $70.05	Professional		$29.84	$43.44	$70.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.64 / $17.93	Professional	26	$8.32	$12.64	$17.93
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.42 / $43.42 / $43.42	Professional	50	$43.42	$43.42	$43.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.88 / $31.20 / $53.02	Professional	TC	$20.88	$31.20	$53.02
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $291.00 / $291.00 / $291.00	Facility		$291.00	$291.00	$291.00
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Professional		$25.00	$25.00	$25.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $39.15 / $45.31 / $85.01	Professional		$39.15	$45.31	$85.01
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.48 / $11.12 / $21.87	Professional	26	$9.48	$11.12	$21.87
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $29.68 / $34.34 / $64.43	Professional	TC	$29.68	$34.34	$64.43
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $88.33 / $281.25 / $431.11	Facility		$88.33	$281.25	$431.11
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $8.81 / $9.16 / $42.95	Facility	26	$8.81	$9.16	$42.95
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $25.37 / $90.02 / $303.02	Facility	TC	$25.37	$90.02	$303.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $36.65 / $62.86	Professional		$24.92	$36.65	$62.86
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $9.16 / $16.10	Professional	26	$7.78	$9.16	$16.10
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $19.72 / $27.53 / $45.72	Professional	TC	$19.72	$27.53	$45.72
United Facility/Professional Professional Modifier Low / Median / High Price $30.35 / $40.13 / $76.79	Professional		$30.35	$40.13	$76.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $11.92 / $20.37	Professional	26	$8.30	$11.92	$20.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.60 / $28.21 / $52.83	Professional	TC	$20.60	$28.21	$52.83