Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.61 / $209.34 / $213.88	Facility		$187.61	$209.34	$213.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.42 / $77.12 / $80.78	Facility	26	$71.42	$77.12	$80.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.03 / $82.23 / $96.21	Professional		$60.03	$82.23	$96.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.85 / $47.75 / $51.33	Professional	26	$35.85	$47.75	$51.33
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $104.00 / $104.00 / $179.00	Professional	50	$104.00	$104.00	$179.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.16 / $34.89 / $41.78	Professional	TC	$24.16	$34.89	$41.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $167.33 / $231.13 / $379.33	Facility		$167.33	$231.13	$379.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.40 / $64.40 / $91.55	Professional		$51.40	$64.40	$91.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.41 / $40.65 / $57.22	Professional	26	$31.41	$40.65	$57.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $77.11 / $96.60 / $137.33	Professional	50	$77.11	$96.60	$137.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.36 / $23.76 / $34.34	Professional	TC	$18.36	$23.76	$34.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.69 / $86.40 / $146.00	Professional		$58.69	$86.40	$146.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.11 / $49.44 / $73.53	Professional	26	$37.11	$49.44	$73.53
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $90.51 / $90.51 / $90.51	Professional	50	$90.51	$90.51	$90.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.58 / $33.20 / $77.80	Professional	TC	$21.58	$33.20	$77.80
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $165.20 / $165.20 / $165.20	Facility		$165.20	$165.20	$165.20
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $59.53 / $104.61	Professional		$34.00	$59.53	$104.61
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $37.10 / $44.45 / $65.84	Professional	26	$37.10	$44.45	$65.84
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $21.85 / $25.28 / $42.84	Professional	TC	$21.85	$25.28	$42.84
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $72.95 / $196.50 / $213.88	Facility		$72.95	$196.50	$213.88
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $61.13 / $71.43 / $80.78	Facility	26	$61.13	$71.43	$80.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $60.03 / $78.22 / $96.21	Professional		$60.03	$78.22	$96.21
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $35.85 / $45.34 / $53.26	Professional	26	$35.85	$45.34	$53.26
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $104.00 / $104.00 / $179.00	Professional	50	$104.00	$104.00	$179.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $21.47 / $30.46 / $42.42	Professional	TC	$21.47	$30.46	$42.42
United Facility/Professional Professional Modifier Low / Median / High Price $50.57 / $115.28 / $155.19	Professional		$50.57	$115.28	$155.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.96 / $69.84 / $90.93	Professional	26	$30.96	$69.84	$90.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.61 / $49.57 / $64.26	Professional	TC	$19.61	$49.57	$64.26