Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.00 / $167.00 / $167.00	Facility	26	$167.00	$167.00	$167.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.65 / $475.00 / $613.72	Professional		$370.65	$475.00	$613.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $140.00 / $167.00	Professional	26	$111.15	$140.00	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $284.27 / $335.00 / $485.57	Professional	TC	$284.27	$335.00	$485.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $374.51 / $484.66 / $708.38	Professional		$374.51	$484.66	$708.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.32 / $114.30 / $174.16	Professional	26	$88.32	$114.30	$174.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $281.67 / $370.00 / $534.22	Professional	TC	$281.67	$370.00	$534.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $458.97 / $662.32 / $1,001.23	Professional		$458.97	$662.32	$1,001.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.34 / $135.38 / $189.34	Professional	26	$86.34	$135.38	$189.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $348.91 / $505.41 / $787.18	Professional	TC	$348.91	$505.41	$787.18
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $422.51 / $508.43 / $917.18	Professional		$422.51	$508.43	$917.18
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $103.87 / $125.00 / $225.48	Professional	26	$103.87	$125.00	$225.48
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $318.63 / $383.43 / $691.68	Professional	TC	$318.63	$383.43	$691.68
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $408.57 / $566.59 / $1,016.00	Professional		$408.57	$566.59	$1,016.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $93.20 / $145.47 / $208.45	Professional	26	$93.20	$145.47	$208.45
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $297.50 / $385.24 / $686.31	Professional	TC	$297.50	$385.24	$686.31
United Facility/Professional Professional Modifier Low / Median / High Price $363.07 / $551.24 / $978.37	Professional		$363.07	$551.24	$978.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.13 / $127.76 / $210.43	Professional	26	$88.13	$127.76	$210.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.43 / $444.74 / $705.69	Professional	TC	$302.43	$444.74	$705.69