Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.62 / $103.62 / $119.80	Facility	26	$103.62	$103.62	$119.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.69 / $392.47 / $476.23	Professional		$309.69	$392.47	$476.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.23 / $91.20 / $132.43	Professional	26	$82.23	$91.20	$132.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $206.08 / $310.24 / $380.79	Professional	TC	$206.08	$310.24	$380.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $284.08 / $388.97 / $643.41	Professional		$284.08	$388.97	$643.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.36 / $115.65 / $176.92	Professional	26	$89.36	$115.65	$176.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $188.37 / $278.22 / $466.49	Professional	TC	$188.37	$278.22	$466.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.96 / $580.04 / $818.01	Professional		$398.96	$580.04	$818.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.87 / $135.69 / $191.63	Professional	26	$90.87	$135.69	$191.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $287.58 / $436.54 / $612.25	Professional	TC	$287.58	$436.54	$612.25
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $383.76 / $461.80 / $833.07	Professional		$383.76	$461.80	$833.07
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $105.52 / $126.99 / $229.06	Professional	26	$105.52	$126.99	$229.06
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $278.24 / $334.82 / $604.00	Professional	TC	$278.24	$334.82	$604.00
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $103.62 / $118.15 / $119.80	Facility	26	$103.62	$118.15	$119.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $309.69 / $438.48 / $660.95	Professional		$309.69	$438.48	$660.95
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $86.74 / $103.62 / $210.94	Professional	26	$86.74	$103.62	$210.94
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $206.08 / $318.13 / $447.54	Professional	TC	$206.08	$318.13	$447.54
United Facility/Professional Professional Modifier Low / Median / High Price $328.42 / $468.19 / $763.80	Professional		$328.42	$468.19	$763.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.70 / $129.28 / $213.81	Professional	26	$91.70	$129.28	$213.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $214.27 / $288.04 / $549.99	Professional	TC	$214.27	$288.04	$549.99