Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.87 / $167.00 / $167.00	Facility	26	$78.87	$167.00	$167.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.72 / $475.00 / $600.00	Professional		$331.72	$475.00	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.79 / $140.00 / $167.00	Professional	26	$104.79	$140.00	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $225.45 / $335.00 / $433.00	Professional	TC	$225.45	$335.00	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.09 / $280.94 / $411.20	Professional		$217.09	$280.94	$411.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.31 / $93.59 / $141.68	Professional	26	$72.31	$93.59	$141.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $142.44 / $186.83 / $269.52	Professional	TC	$142.44	$186.83	$269.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.47 / $407.23 / $911.60	Professional		$266.47	$407.23	$911.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.06 / $111.19 / $155.22	Professional	26	$70.06	$111.19	$155.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.22 / $280.91 / $647.00	Professional	TC	$177.22	$280.91	$647.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $245.26 / $295.13 / $532.41	Professional		$245.26	$295.13	$532.41
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $84.50 / $101.69 / $183.43	Professional	26	$84.50	$101.69	$183.43
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $160.76 / $193.45 / $348.98	Professional	TC	$160.76	$193.45	$348.98
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $78.87 / $94.78 / $167.00	Facility	26	$78.87	$94.78	$167.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $241.73 / $475.00 / $736.43	Professional		$241.73	$475.00	$736.43
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $83.26 / $140.00 / $170.01	Professional	26	$83.26	$140.00	$170.01
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $159.12 / $335.00 / $433.00	Professional	TC	$159.12	$335.00	$433.00
United Facility/Professional Professional Modifier Low / Median / High Price $228.05 / $451.34 / $583.63	Professional		$228.05	$451.34	$583.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $104.20 / $172.84	Professional	26	$74.13	$104.20	$172.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $153.74 / $347.14 / $418.96	Professional	TC	$153.74	$347.14	$418.96