Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $245.47 / $501.19	Facility		$85.11	$245.47	$501.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $10.47 / $51.29	Facility	26	$9.55	$10.47	$51.29
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $117.49 / $380.19	Facility	TC	$33.11	$117.49	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $43.65 / $93.33	Professional		$14.13	$43.65	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $38.02	Professional	26	$7.08	$10.96	$38.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $91.20 / $199.53	Professional	50	$50.12	$91.20	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $38.90 / $77.62	Professional	TC	$21.88	$38.90	$77.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $117.49 / $117.49	Facility		$95.50	$117.49	$117.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $46.77 / $67.61	Professional		$31.62	$46.77	$67.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.72 / $15.85	Professional	26	$6.76	$10.72	$15.85
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $69.18 / $102.33	Professional	50	$47.86	$69.18	$102.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $34.67 / $50.12	Professional	TC	$24.55	$34.67	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $46.77 / $83.18	Professional		$29.51	$46.77	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.02 / $20.89	Professional	26	$8.32	$12.02	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $35.48 / $64.57	Professional	TC	$20.89	$35.48	$64.57
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Facility		$407.38	$407.38	$407.38
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $42.66 / $58.88	Professional		$38.02	$42.66	$58.88
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $56.23 / $112.20	Professional		$43.65	$56.23	$112.20
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.59 / $25.12	Professional	26	$10.00	$12.59	$25.12
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $43.65 / $81.28	Professional	TC	$34.67	$43.65	$81.28
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $257.04 / $489.78	Facility		$51.29	$257.04	$489.78
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $10.00 / $51.29	Facility	26	$9.55	$10.00	$51.29
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $117.49 / $389.05	Facility	TC	$33.11	$117.49	$389.05
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $44.67 / $89.13	Professional		$17.38	$44.67	$89.13
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.75 / $28.84	Professional	26	$7.94	$11.75	$28.84
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $91.20 / $204.17	Professional	50	$50.12	$91.20	$204.17
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $36.31 / $75.86	Professional	TC	$24.55	$36.31	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $46.77 / $91.20	Professional		$32.36	$46.77	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.30 / $22.39	Professional	26	$8.71	$12.30	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $35.48 / $63.10	Professional	TC	$23.99	$35.48	$63.10