Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.66 / $274.43 / $497.17	Facility		$87.66	$274.43	$497.17
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.97 / $9.97 / $213.57	Facility	26	$9.97	$9.97	$213.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.42 / $105.06 / $393.38	Facility	TC	$29.42	$105.06	$393.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.08 / $38.57 / $68.37	Professional		$24.08	$38.57	$68.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.55 / $14.34	Professional	26	$7.33	$8.55	$14.34
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $55.80 / $55.80 / $112.99	Professional	50	$55.80	$55.80	$112.99
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.04 / $16.46 / $19.70	Professional	52	$12.04	$16.46	$19.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $26.88 / $48.42	Professional	TC	$21.94	$26.88	$48.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.80 / $118.52 / $194.52	Facility		$85.80	$118.52	$194.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.28 / $48.42 / $69.95	Professional		$35.28	$48.42	$69.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $11.41 / $15.89	Professional	26	$8.09	$11.41	$15.89
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $52.93 / $72.63 / $104.92	Professional	50	$52.93	$72.63	$104.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.17 / $36.26 / $54.03	Professional	TC	$27.17	$36.26	$54.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.72 / $48.30 / $82.06	Professional		$33.72	$48.30	$82.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.36 / $19.52	Professional	26	$8.32	$13.36	$19.52
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $49.18 / $49.18 / $49.18	Professional	50	$49.18	$49.18	$49.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.74 / $37.39 / $63.52	Professional	TC	$23.74	$37.39	$63.52
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $404.00 / $404.00 / $404.00	Facility		$404.00	$404.00	$404.00
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $38.00 / $49.36	Professional		$38.00	$38.00	$49.36
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $44.93 / $54.07 / $97.53	Professional		$44.93	$54.07	$97.53
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $10.31 / $12.40 / $22.38	Professional	26	$10.31	$12.40	$22.38
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $34.61 / $41.67 / $75.15	Professional	TC	$34.61	$41.67	$75.15
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $49.89 / $263.76 / $465.22	Facility		$49.89	$263.76	$465.22
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $9.59 / $10.11 / $320.92	Facility	26	$9.59	$10.11	$320.92
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $29.42 / $113.63 / $405.84	Facility	TC	$29.42	$113.63	$405.84
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $29.28 / $40.93 / $68.98	Professional		$29.28	$40.93	$68.98
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $9.97 / $17.50	Professional	26	$7.78	$9.97	$17.50
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $55.80 / $55.80 / $112.99	Professional	50	$55.80	$55.80	$112.99
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $12.29 / $19.70 / $30.06	Professional	52	$12.29	$19.70	$30.06
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $24.60 / $30.35 / $53.39	Professional	TC	$24.60	$30.35	$53.39
United Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $46.24 / $85.53	Professional		$35.36	$46.24	$85.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $12.50 / $20.77	Professional	26	$9.02	$12.50	$20.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.35 / $31.24 / $61.25	Professional	TC	$26.35	$31.24	$61.25