Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $143.58 / $167.00 / $167.00	Facility	26	$143.58	$167.00	$167.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $372.28 / $475.00 / $609.30	Professional		$372.28	$475.00	$609.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $145.65 / $194.16	Professional	26	$111.15	$145.65	$194.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $266.14 / $335.00 / $450.68	Professional	TC	$266.14	$335.00	$450.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $377.69 / $488.78 / $710.45	Professional		$377.69	$488.78	$710.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $108.22 / $140.69 / $214.93	Professional	26	$108.22	$140.69	$214.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $262.39 / $348.08 / $495.52	Professional	TC	$262.39	$348.08	$495.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $464.20 / $712.80 / $1,260.91	Professional		$464.20	$712.80	$1,260.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.94 / $165.09 / $232.61	Professional	26	$107.94	$165.09	$232.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $329.16 / $486.28 / $1,097.93	Professional	TC	$329.16	$486.28	$1,097.93
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $423.74 / $509.92 / $919.85	Professional		$423.74	$509.92	$919.85
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $128.19 / $154.27 / $278.27	Professional	26	$128.19	$154.27	$278.27
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $295.55 / $355.65 / $641.58	Professional	TC	$295.55	$355.65	$641.58
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $143.58 / $143.58 / $143.58	Facility	26	$143.58	$143.58	$143.58
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $407.86 / $586.16 / $1,016.00	Professional		$407.86	$586.16	$1,016.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $115.19 / $167.00 / $254.90	Professional	26	$115.19	$167.00	$254.90
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $292.67 / $401.83 / $500.36	Professional	TC	$292.67	$401.83	$500.36
United Facility/Professional Professional Modifier Low / Median / High Price $396.63 / $686.14 / $924.77	Professional		$396.63	$686.14	$924.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.84 / $161.69 / $258.43	Professional	26	$110.84	$161.69	$258.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.65 / $524.44 / $711.62	Professional	TC	$242.65	$524.44	$711.62