Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.00 / $167.00 / $167.00	Facility	26	$167.00	$167.00	$167.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $475.00 / $697.67	Professional		$425.00	$475.00	$697.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $140.00 / $167.00	Professional	26	$111.15	$140.00	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $297.50 / $335.00 / $542.08	Professional	TC	$297.50	$335.00	$542.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $434.17 / $561.86 / $806.51	Professional		$434.17	$561.86	$806.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.06 / $137.25 / $210.79	Professional	26	$106.06	$137.25	$210.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $317.73 / $423.91 / $595.73	Professional	TC	$317.73	$423.91	$595.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $534.49 / $824.77 / $1,251.86	Professional		$534.49	$824.77	$1,251.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.99 / $160.97 / $228.03	Professional	26	$102.99	$160.97	$228.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $402.13 / $592.20 / $1,123.59	Professional	TC	$402.13	$592.20	$1,123.59
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $481.04 / $578.86 / $1,044.24	Professional		$481.04	$578.86	$1,044.24
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $125.72 / $151.29 / $272.91	Professional	26	$125.72	$151.29	$272.91
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $355.32 / $427.58 / $771.33	Professional	TC	$355.32	$427.58	$771.33
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $462.17 / $600.00 / $1,040.40	Professional		$462.17	$600.00	$1,040.40
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $125.78 / $166.42 / $250.85	Professional	26	$125.78	$166.42	$250.85
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $433.00 / $786.46	Professional	TC	$335.00	$433.00	$786.46
United Facility/Professional Professional Modifier Low / Median / High Price $423.08 / $667.38 / $1,139.80	Professional		$423.08	$667.38	$1,139.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.67 / $153.74 / $253.37	Professional	26	$108.67	$153.74	$253.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $317.07 / $483.94 / $869.21	Professional	TC	$317.07	$483.94	$869.21