Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.23 / $15.23 / $15.23	Facility	26	$15.23	$15.23	$15.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.85 / $112.58 / $121.80	Facility	TC	$31.85	$112.58	$121.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.60 / $40.51 / $71.67	Professional		$31.60	$40.51	$71.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.06 / $13.49 / $20.82	Professional	26	$12.06	$13.49	$20.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.06 / $26.65 / $51.90	Professional	TC	$21.06	$26.65	$51.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $56.79 / $82.02	Professional		$41.40	$56.79	$82.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $17.35 / $24.16	Professional	26	$12.29	$17.35	$24.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.11 / $38.86 / $57.85	Professional	TC	$29.11	$38.86	$57.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.55 / $56.89 / $96.34	Professional		$44.55	$56.89	$96.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.77 / $20.39 / $29.81	Professional	26	$14.77	$20.39	$29.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.78 / $40.04 / $68.02	Professional	TC	$26.78	$40.04	$68.02
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $52.76 / $64.76 / $121.69	Professional		$52.76	$64.76	$121.69
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $15.66 / $18.84 / $33.99	Professional	26	$15.66	$18.84	$33.99
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $37.10 / $44.64 / $80.54	Professional	TC	$37.10	$44.64	$80.54
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $109.93 / $112.58 / $121.80	Facility	TC	$109.93	$112.58	$121.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $47.09 / $81.06	Professional		$35.22	$47.09	$81.06
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.06 / $15.23 / $23.82	Professional	26	$12.06	$15.23	$23.82
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $31.86 / $57.23	Professional	TC	$23.17	$31.86	$57.23
United Facility/Professional Professional Modifier Low / Median / High Price $42.22 / $56.62 / $104.68	Professional		$42.22	$56.62	$104.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.71 / $19.44 / $31.71	Professional	26	$13.71	$19.44	$31.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.51 / $38.60 / $70.81	Professional	TC	$28.51	$38.60	$70.81