Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.56 / $167.00 / $298.48	Facility	26	$73.56	$167.00	$298.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.66 / $475.00 / $600.00	Professional		$290.66	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.01 / $140.00 / $167.00	Professional	26	$98.01	$140.00	$167.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $475.00 / $475.00 / $475.00	Professional	50	$475.00	$475.00	$475.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $110.68 / $212.50 / $300.00	Professional	52	$110.68	$212.50	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.74 / $335.00 / $433.00	Professional	TC	$220.74	$335.00	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.43 / $289.14 / $427.79	Professional		$223.43	$289.14	$427.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.45 / $87.30 / $132.00	Professional	26	$67.45	$87.30	$132.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $335.15 / $433.73 / $641.67	Professional	50	$335.15	$433.73	$641.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.94 / $200.99 / $295.79	Professional	TC	$154.94	$200.99	$295.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.95 / $416.06 / $884.79	Professional		$271.95	$416.06	$884.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.39 / $102.09 / $145.30	Professional	26	$64.39	$102.09	$145.30
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $343.71 / $343.71 / $343.71	Professional	50	$343.71	$343.71	$343.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.52 / $280.79 / $637.65	Professional	TC	$188.52	$280.79	$637.65
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $311.00 / $311.00 / $440.48	Professional		$311.00	$311.00	$440.48
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $255.15 / $307.04 / $553.88	Professional		$255.15	$307.04	$553.88
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $78.73 / $94.74 / $170.91	Professional	26	$78.73	$94.74	$170.91
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $176.42 / $212.30 / $382.97	Professional	TC	$176.42	$212.30	$382.97
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $89.55 / $298.48	Facility	26	$68.70	$89.55	$298.48
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $245.49 / $475.00 / $655.50	Professional		$245.49	$475.00	$655.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $77.59 / $140.00 / $167.00	Professional	26	$77.59	$140.00	$167.00
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $475.00 / $475.00 / $475.00	Professional	50	$475.00	$475.00	$475.00
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $117.63 / $212.50 / $300.00	Professional	52	$117.63	$212.50	$300.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $174.44 / $335.00 / $433.00	Professional	TC	$174.44	$335.00	$433.00
United Facility/Professional Professional Modifier Low / Median / High Price $215.17 / $325.39 / $577.17	Professional		$215.17	$325.39	$577.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.59 / $97.07 / $159.91	Professional	26	$68.59	$97.07	$159.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.13 / $231.92 / $406.91	Professional	TC	$163.13	$231.92	$406.91