Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.93 / $167.00 / $167.00	Facility	26	$87.93	$167.00	$167.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $355.33 / $475.00 / $600.00	Professional		$355.33	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.38 / $140.00 / $167.00	Professional	26	$97.38	$140.00	$167.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $712.50 / $712.50 / $712.50	Professional	50	$712.50	$712.50	$712.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $433.00	Professional	TC	$259.35	$335.00	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $248.84 / $322.02 / $467.87	Professional		$248.84	$322.02	$467.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.76 / $86.40 / $131.31	Professional	26	$66.76	$86.40	$131.31
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $373.26 / $483.05 / $701.80	Professional	50	$373.26	$483.05	$701.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $178.50 / $235.24 / $336.57	Professional	TC	$178.50	$235.24	$336.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $305.10 / $468.34 / $943.28	Professional		$305.10	$468.34	$943.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.39 / $101.20 / $143.27	Professional	26	$64.39	$101.20	$143.27
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $386.61 / $386.61 / $386.61	Professional	50	$386.61	$386.61	$386.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $222.36 / $348.16 / $659.32	Professional	TC	$222.36	$348.16	$659.32
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $279.06 / $335.81 / $605.78	Professional		$279.06	$335.81	$605.78
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $78.31 / $94.24 / $170.02	Professional	26	$78.31	$94.24	$170.02
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $200.74 / $241.57 / $435.77	Professional	TC	$200.74	$241.57	$435.77
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $87.93 / $87.93 / $87.93	Facility	26	$87.93	$87.93	$87.93
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $269.43 / $475.00 / $749.68	Professional		$269.43	$475.00	$749.68
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $77.20 / $140.00 / $167.00	Professional	26	$77.20	$140.00	$167.00
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $712.50 / $712.50 / $712.50	Professional	50	$712.50	$712.50	$712.50
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $206.25 / $335.00 / $433.00	Professional	TC	$206.25	$335.00	$433.00
United Facility/Professional Professional Modifier Low / Median / High Price $261.64 / $492.83 / $643.65	Professional		$261.64	$492.83	$643.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.23 / $96.59 / $159.08	Professional	26	$68.23	$96.59	$159.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.74 / $379.52 / $480.22	Professional	TC	$200.74	$379.52	$480.22