Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	26	$165.96	$165.96	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $446.68 / $1,023.29	Professional		$346.74	$446.68	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $120.23 / $275.42	Professional	26	$85.11	$120.23	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $776.25	Professional	TC	$257.04	$338.84	$776.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $489.78 / $1,230.27	Professional		$338.84	$489.78	$1,230.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $123.03 / $281.84	Professional	26	$83.18	$123.03	$281.84
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $501.19 / $741.31 / $1,862.09	Professional	50	$501.19	$741.31	$1,862.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $371.54 / $954.99	Professional	TC	$257.04	$371.54	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $660.69 / $1,148.15	Professional		$457.09	$660.69	$1,148.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $125.89 / $239.88	Professional	26	$85.11	$125.89	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $501.19 / $912.01	Professional	TC	$309.03	$501.19	$912.01
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $512.86 / $1,000.00	Professional		$407.38	$512.86	$1,000.00
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $125.89 / $234.42	Professional	26	$100.00	$125.89	$234.42
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $389.05 / $758.58	Professional	TC	$309.03	$389.05	$758.58
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $575.44 / $1,348.96	Professional		$371.54	$575.44	$1,348.96
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $131.83 / $288.40	Professional	26	$100.00	$131.83	$288.40
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $416.87 / $954.99	Professional	TC	$263.03	$416.87	$954.99
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $549.54 / $1,000.00	Professional		$363.08	$549.54	$1,000.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $128.82 / $234.42	Professional	26	$89.13	$128.82	$234.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $416.87 / $812.83	Professional	TC	$275.42	$416.87	$812.83