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 $399.88 / $475.00 / $612.66	Professional		$399.88	$475.00	$612.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.72 / $145.65 / $227.68	Professional	26	$124.72	$145.65	$227.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $275.16 / $335.00 / $433.00	Professional	TC	$275.16	$335.00	$433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $400.19 / $529.44 / $758.14	Professional		$400.19	$529.44	$758.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.74 / $163.35 / $251.56	Professional	26	$117.74	$163.35	$251.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $268.08 / $364.06 / $506.58	Professional	TC	$268.08	$364.06	$506.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $503.98 / $713.08 / $1,150.00	Professional		$503.98	$713.08	$1,150.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.62 / $192.03 / $273.86	Professional	26	$129.62	$192.03	$273.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $345.88 / $508.58 / $806.31	Professional	TC	$345.88	$508.58	$806.31
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $452.18 / $530.50 / $981.59	Professional		$452.18	$530.50	$981.59
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $150.04 / $176.03 / $325.70	Professional	26	$150.04	$176.03	$325.70
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $302.14 / $363.59 / $655.89	Professional	TC	$302.14	$363.59	$655.89
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $597.91 / $780.77	Professional		$425.00	$597.91	$780.77
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $127.50 / $167.00 / $269.20	Professional	26	$127.50	$167.00	$269.20
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $297.50 / $385.24 / $511.55	Professional	TC	$297.50	$385.24	$511.55
United Facility/Professional Professional Modifier Low / Median / High Price $395.64 / $576.20 / $993.00	Professional		$395.64	$576.20	$993.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $126.19 / $182.83 / $302.80	Professional	26	$126.19	$182.83	$302.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $296.30 / $414.82 / $691.64	Professional	TC	$296.30	$414.82	$691.64