Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $15.14	Facility	26	$15.14	$15.14	$15.14
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $112.20 / $114.82 / $123.03	Facility	TC	$112.20	$114.82	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $42.66 / $85.11	Professional		$30.90	$42.66	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.80 / $28.84	Professional	26	$10.00	$13.80	$28.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $47.86	Professional	TC	$20.89	$30.20	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $54.95 / $81.28	Professional		$28.84	$54.95	$81.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $16.22 / $23.99	Professional	26	$8.13	$16.22	$23.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $37.15 / $54.95	Professional	TC	$20.89	$37.15	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $56.23 / $97.72	Professional		$40.74	$56.23	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $17.78 / $31.62	Professional	26	$14.79	$17.78	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.02 / $69.18	Professional	TC	$26.92	$38.02	$69.18
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $120.23	Professional		$51.29	$64.57	$120.23
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $18.62 / $35.48	Professional	26	$14.79	$18.62	$35.48
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $45.71 / $89.13	Professional	TC	$36.31	$45.71	$89.13
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $112.20 / $114.82 / $123.03	Facility	TC	$112.20	$114.82	$123.03
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $51.29 / $95.50	Professional		$35.48	$51.29	$95.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.22 / $30.90	Professional	26	$10.96	$16.22	$30.90
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $35.48 / $66.07	Professional	TC	$23.99	$35.48	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $54.95 / $107.15	Professional		$38.90	$54.95	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.05 / $34.67	Professional	26	$13.18	$19.05	$34.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $70.79	Professional	TC	$25.70	$37.15	$70.79