Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $283.00 / $5,396.10 / $5,396.10	Facility		$283.00	$5,396.10	$5,396.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.04 / $96.04 / $96.04	Facility	26	$96.04	$96.04	$96.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.12 / $211.53 / $253.96	Professional		$128.12	$211.53	$253.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $54.31 / $121.90	Professional	26	$48.86	$54.31	$121.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $64.06 / $92.11 / $118.73	Professional	52	$64.06	$92.11	$118.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.52 / $162.66 / $199.64	Professional	TC	$84.52	$162.66	$199.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $910.94 / $1,258.29 / $2,065.11	Facility		$910.94	$1,258.29	$2,065.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.94 / $206.47 / $286.12	Professional		$151.94	$206.47	$286.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.53 / $111.46 / $154.51	Professional	26	$79.53	$111.46	$154.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.84 / $95.01 / $131.63	Professional	TC	$67.84	$95.01	$131.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $185.75 / $283.94 / $547.64	Professional		$185.75	$283.94	$547.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.59 / $105.11 / $187.15	Professional	26	$65.59	$105.11	$187.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $86.76 / $131.85 / $464.18	Professional	TC	$86.76	$131.85	$464.18
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $83.26 / $183.02 / $397.30	Professional		$83.26	$183.02	$397.30
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $115.41 / $155.21 / $230.07	Professional	26	$115.41	$155.21	$230.07
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $96.33 / $129.55 / $192.04	Professional	TC	$96.33	$129.55	$192.04
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $283.00 / $3,864.38 / $5,396.10	Facility		$283.00	$3,864.38	$5,396.10
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $158.96 / $235.93 / $317.05	Professional		$158.96	$235.93	$317.05
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $86.79 / $148.21	Professional	26	$48.86	$86.79	$148.21
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $63.23 / $92.11 / $123.96	Professional	52	$63.23	$92.11	$123.96
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $82.21 / $128.47 / $199.64	Professional	TC	$82.21	$128.47	$199.64
United Facility/Professional Professional Modifier Low / Median / High Price $155.66 / $223.37 / $409.53	Professional		$155.66	$223.37	$409.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.23 / $88.42 / $199.96	Professional	26	$74.23	$88.42	$199.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.67 / $141.78 / $185.75	Professional	TC	$78.67	$141.78	$185.75