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 $370.50 / $475.00 / $600.00	Professional		$370.50	$475.00	$600.00
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 $281.79 / $335.00 / $453.28	Professional	TC	$281.79	$335.00	$453.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $369.85 / $481.93 / $708.38	Professional		$369.85	$481.93	$708.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.62 / $114.75 / $175.54	Professional	26	$82.62	$114.75	$175.54
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $554.78 / $722.89 / $1,062.57	Professional	50	$554.78	$722.89	$1,062.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $276.60 / $366.81 / $532.84	Professional	TC	$276.60	$366.81	$532.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.03 / $665.17 / $995.50	Professional		$457.03	$665.17	$995.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.09 / $136.46 / $190.11	Professional	26	$87.09	$136.46	$190.11
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $580.67 / $580.67 / $580.67	Professional	50	$580.67	$580.67	$580.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $346.47 / $504.10 / $789.48	Professional	TC	$346.47	$504.10	$789.48
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $422.51 / $508.43 / $917.18	Professional		$422.51	$508.43	$917.18
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $104.70 / $125.99 / $227.28	Professional	26	$104.70	$125.99	$227.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $317.81 / $382.43 / $689.90	Professional	TC	$317.81	$382.43	$689.90
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $389.86 / $576.96 / $895.94	Professional		$389.86	$576.96	$895.94
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $140.00 / $187.56	Professional	26	$111.15	$140.00	$187.56
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $294.75 / $420.60 / $631.87	Professional	TC	$294.75	$420.60	$631.87
United Facility/Professional Professional Modifier Low / Median / High Price $362.15 / $600.38 / $749.91	Professional		$362.15	$600.38	$749.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.03 / $142.13 / $226.52	Professional	26	$92.03	$142.13	$226.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $273.30 / $415.29 / $749.14	Professional	TC	$273.30	$415.29	$749.14