Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $257.04 / $426.58	Facility		$89.13	$257.04	$426.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $9.55 / $42.66	Facility	26	$8.71	$9.55	$42.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $93.33 / $302.00	Facility	TC	$25.12	$93.33	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $36.31 / $81.28	Professional		$13.80	$36.31	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.47 / $28.18	Professional	26	$6.92	$10.47	$28.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $77.62 / $120.23	Professional	50	$46.77	$77.62	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $30.90 / $70.79	Professional	TC	$17.38	$30.90	$70.79
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $97.72 / $97.72	Facility		$79.43	$97.72	$97.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $40.74 / $58.88	Professional		$26.92	$40.74	$58.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $10.00 / $14.79	Professional	26	$6.31	$10.00	$14.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $40.74 / $61.66 / $89.13	Professional	50	$40.74	$61.66	$89.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $43.65	Professional	TC	$20.89	$30.20	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $72.44	Professional		$26.92	$41.69	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.48 / $19.05	Professional	26	$8.13	$11.48	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $54.95	Professional	TC	$19.05	$30.20	$54.95
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Facility		$288.40	$288.40	$288.40
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Professional		$25.12	$25.12	$25.12
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $47.86 / $95.50	Professional		$37.15	$47.86	$95.50
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.75 / $21.88	Professional	26	$9.33	$11.75	$21.88
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $37.15 / $72.44	Professional	TC	$28.18	$37.15	$72.44
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $269.15 / $416.87	Facility		$89.13	$269.15	$416.87
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $9.12 / $42.66	Facility	26	$8.71	$9.12	$42.66
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $93.33 / $302.00	Facility	TC	$25.12	$93.33	$302.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $38.02 / $75.86	Professional		$15.14	$38.02	$75.86
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $10.96 / $25.12	Professional	26	$7.24	$10.96	$25.12
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $56.23 / $199.53	Professional	50	$46.77	$56.23	$199.53
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.20 / $61.66	Professional	TC	$19.95	$30.20	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $41.69 / $79.43	Professional		$28.84	$41.69	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.75 / $20.42	Professional	26	$7.94	$11.75	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $29.51 / $52.48	Professional	TC	$20.42	$29.51	$52.48