Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.96 / $57.25 / $64.84	Facility	26	$56.96	$57.25	$64.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.75 / $221.44 / $266.64	Professional		$140.75	$221.44	$266.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $50.67 / $80.79	Professional	26	$43.82	$50.67	$80.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.96 / $162.55 / $217.98	Professional	TC	$109.96	$162.55	$217.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.54 / $183.17 / $272.98	Professional		$141.54	$183.17	$272.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.70 / $64.34 / $96.75	Professional	26	$49.70	$64.34	$96.75
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $212.31 / $274.75 / $409.47	Professional	50	$212.31	$274.75	$409.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.01 / $118.77 / $176.23	Professional	TC	$91.01	$118.77	$176.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.11 / $256.80 / $415.18	Professional		$174.11	$256.80	$415.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.92 / $75.98 / $106.37	Professional	26	$50.92	$75.98	$106.37
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $264.70 / $264.70 / $264.70	Professional	50	$264.70	$264.70	$264.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.24 / $172.30 / $302.86	Professional	TC	$113.24	$172.30	$302.86
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $162.82 / $195.93 / $353.45	Professional		$162.82	$195.93	$353.45
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $57.71 / $69.44 / $125.28	Professional	26	$57.71	$69.44	$125.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $105.11 / $126.49 / $228.17	Professional	TC	$105.11	$126.49	$228.17
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $53.97 / $57.25 / $65.73	Facility	26	$53.97	$57.25	$65.73
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $156.21 / $218.21 / $281.63	Professional		$156.21	$218.21	$281.63
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $46.61 / $57.25 / $103.67	Professional	26	$46.61	$57.25	$103.67
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $109.96 / $141.74 / $220.39	Professional	TC	$109.96	$141.74	$220.39
United Facility/Professional Professional Modifier Low / Median / High Price $156.85 / $243.46 / $390.56	Professional		$156.85	$243.46	$390.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.43 / $71.55 / $126.15	Professional	26	$49.43	$71.55	$126.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.47 / $171.91 / $264.41	Professional	TC	$96.47	$171.91	$264.41