Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.43 / $104.43 / $653.78	Facility	26	$104.43	$104.43	$653.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $306.68 / $365.54 / $516.04	Professional		$306.68	$365.54	$516.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.45 / $91.06 / $147.49	Professional	26	$76.45	$91.06	$147.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $230.22 / $270.23 / $382.43	Professional	TC	$230.22	$270.23	$382.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.57 / $411.15 / $635.12	Professional		$323.57	$411.15	$635.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.41 / $117.00 / $178.30	Professional	26	$90.41	$117.00	$178.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $222.19 / $298.89 / $456.82	Professional	TC	$222.19	$298.89	$456.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $361.62 / $497.35 / $731.47	Professional		$361.62	$497.35	$731.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.68 / $137.22 / $193.92	Professional	26	$92.68	$137.22	$193.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $260.62 / $349.06 / $537.55	Professional	TC	$260.62	$349.06	$537.55
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $356.71 / $416.00 / $594.52	Professional		$356.71	$416.00	$594.52
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $378.81 / $455.84 / $822.32	Professional		$378.81	$455.84	$822.32
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $106.35 / $127.98 / $230.86	Professional	26	$106.35	$127.98	$230.86
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $272.45 / $327.88 / $591.46	Professional	TC	$272.45	$327.88	$591.46
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $99.11 / $104.59 / $653.78	Facility	26	$99.11	$104.59	$653.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $334.49 / $374.67 / $651.79	Professional		$334.49	$374.67	$651.79
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $81.01 / $104.43 / $181.03	Professional	26	$81.01	$104.43	$181.03
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $252.90 / $270.23 / $461.44	Professional	TC	$252.90	$270.23	$461.44
United Facility/Professional Professional Modifier Low / Median / High Price $307.39 / $440.93 / $822.32	Professional		$307.39	$440.93	$822.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.42 / $130.22 / $230.13	Professional	26	$92.42	$130.22	$230.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $238.92 / $323.58 / $591.46	Professional	TC	$238.92	$323.58	$591.46