Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $117.49 / $117.49	Facility	26	$117.49	$117.49	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $13.18 / $33.88	Professional		$10.47	$13.18	$33.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.91 / $19.05	Professional	26	$7.08	$8.91	$19.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $12.30 / $12.30 / $12.30	Professional	50	$12.30	$12.30	$12.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.98 / $8.51	Professional	TC	$3.02	$3.98	$8.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $19.95 / $19.95	Facility		$15.85	$19.95	$19.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $16.22 / $23.44	Professional		$10.00	$16.22	$23.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $10.96 / $15.85	Professional	26	$6.46	$10.96	$15.85
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $14.79 / $23.99 / $33.11	Professional	50	$14.79	$23.99	$33.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.47 / $5.25 / $7.59	Professional	TC	$3.47	$5.25	$7.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $16.98 / $25.70	Professional		$11.75	$16.98	$25.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $12.02 / $18.62	Professional	26	$7.41	$12.02	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.09 / $5.25 / $8.13	Professional	TC	$3.09	$5.25	$8.13
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $17.78 / $33.11	Professional		$9.77	$17.78	$33.11
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.49 / $21.88	Professional	26	$9.33	$13.49	$21.88
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $4.68 / $6.03 / $9.77	Professional	TC	$4.68	$6.03	$9.77
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $117.49 / $117.49	Facility	26	$117.49	$117.49	$117.49
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $14.45 / $28.84	Professional		$10.23	$14.45	$28.84
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.55 / $19.05	Professional	26	$7.08	$9.55	$19.05
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $12.30 / $12.30 / $12.30	Professional	50	$12.30	$12.30	$12.30
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $4.57 / $9.12	Professional	TC	$3.02	$4.57	$9.12
United Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $19.95 / $30.90	Professional		$11.22	$19.95	$30.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.18 / $20.89	Professional	26	$7.94	$13.18	$20.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.24 / $6.46 / $10.00	Professional	TC	$3.24	$6.46	$10.00