Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.75 / $58.75 / $58.75	Facility	26	$58.75	$58.75	$58.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.45 / $130.80 / $252.95	Professional		$109.45	$130.80	$252.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.27 / $34.93 / $75.34	Professional	26	$26.27	$34.93	$75.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.54 / $97.58 / $177.61	Professional	TC	$79.54	$97.58	$177.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.51 / $214.65 / $292.48	Professional		$147.51	$214.65	$292.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.90 / $60.69 / $92.20	Professional	26	$46.90	$60.69	$92.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.39 / $145.79 / $200.30	Professional	TC	$103.39	$145.79	$200.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.80 / $210.21 / $355.43	Professional		$126.80	$210.21	$355.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.90 / $63.85 / $114.22	Professional	26	$34.90	$63.85	$114.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.49 / $144.26 / $258.05	Professional	TC	$93.49	$144.26	$258.05
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $186.31 / $224.20 / $404.44	Professional		$186.31	$224.20	$404.44
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $59.77 / $71.92 / $129.75	Professional	26	$59.77	$71.92	$129.75
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $126.55 / $152.28 / $274.70	Professional	TC	$126.55	$152.28	$274.70
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $121.81 / $174.86 / $286.61	Professional		$121.81	$174.86	$286.61
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $58.75 / $84.01	Professional	26	$31.76	$58.75	$84.01
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $89.03 / $116.10 / $195.74	Professional	TC	$89.03	$116.10	$195.74
United Facility/Professional Professional Modifier Low / Median / High Price $145.37 / $213.29 / $364.03	Professional		$145.37	$213.29	$364.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.27 / $53.66 / $97.59	Professional	26	$47.27	$53.66	$97.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.58 / $164.08 / $258.11	Professional	TC	$103.58	$164.08	$258.11