Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $58.88 / $58.88	Facility	26	$51.29	$58.88	$58.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $144.54 / $263.03	Professional		$100.00	$144.54	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $45.71 / $104.71	Professional	26	$28.18	$45.71	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $102.33 / $181.97	Professional	TC	$74.13	$102.33	$181.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $177.83 / $263.03	Professional		$123.03	$177.83	$263.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $52.48 / $79.43	Professional	26	$34.67	$52.48	$79.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $125.89 / $181.97	Professional	TC	$89.13	$125.89	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $186.21 / $309.03	Professional		$112.20	$186.21	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $56.23 / $104.71	Professional	26	$33.11	$56.23	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $128.82 / $218.78	Professional	TC	$74.13	$128.82	$218.78
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $380.19	Professional		$158.49	$204.17	$380.19
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $63.10 / $117.49	Professional	26	$50.12	$63.10	$117.49
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $141.25 / $263.03	Professional	TC	$112.20	$141.25	$263.03
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Facility	26	$58.88	$58.88	$58.88
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $173.78 / $331.13	Professional		$120.23	$173.78	$331.13
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $57.54 / $104.71	Professional	26	$33.11	$57.54	$104.71
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $123.03 / $234.42	Professional	TC	$89.13	$123.03	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $363.08	Professional		$131.83	$181.97	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $54.95 / $97.72	Professional	26	$41.69	$54.95	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $128.82 / $234.42	Professional	TC	$85.11	$128.82	$234.42