Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $355.23 / $633.02 / $716.01	Facility		$355.23	$633.02	$716.01
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.94 / $31.94 / $158.97	Facility	26	$31.94	$31.94	$158.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.34 / $130.35 / $207.83	Professional		$107.34	$130.35	$207.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $28.08 / $45.35	Professional	26	$24.07	$28.08	$45.35
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $45.40 / $60.27 / $65.92	Professional	52	$45.40	$60.27	$65.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.28 / $94.28 / $143.18	Professional	TC	$83.28	$94.28	$143.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $324.62 / $448.40 / $735.92	Facility		$324.62	$448.40	$735.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.94 / $153.93 / $210.46	Professional		$118.94	$153.93	$210.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.59 / $37.00 / $50.23	Professional	26	$28.59	$37.00	$50.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $90.36 / $116.94 / $160.22	Professional	TC	$90.36	$116.94	$160.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.28 / $159.79 / $251.70	Professional		$104.28	$159.79	$251.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.16 / $42.06 / $59.87	Professional	26	$26.16	$42.06	$59.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.51 / $121.09 / $191.83	Professional	TC	$72.51	$121.09	$191.83
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $555.50 / $555.50 / $555.50	Facility		$555.50	$555.50	$555.50
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $128.00 / $128.00 / $128.00	Professional		$128.00	$128.00	$128.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $135.19 / $161.97 / $239.97	Professional		$135.19	$161.97	$239.97
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $32.97 / $39.51 / $58.54	Professional	26	$32.97	$39.51	$58.54
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $102.23 / $122.48 / $181.45	Professional	TC	$102.23	$122.48	$181.45
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $147.03 / $605.73 / $716.01	Facility		$147.03	$605.73	$716.01
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $30.74 / $32.43 / $163.26	Facility	26	$30.74	$32.43	$163.26
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $117.57 / $131.84 / $207.83	Professional		$117.57	$131.84	$207.83
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $31.94 / $49.95	Professional	26	$24.07	$31.94	$49.95
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $45.40 / $65.92 / $90.67	Professional	52	$45.40	$65.92	$90.67
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $83.28 / $99.90 / $157.85	Professional	TC	$83.28	$99.90	$157.85
United Facility/Professional Professional Modifier Low / Median / High Price $100.31 / $158.62 / $274.47	Professional		$100.31	$158.62	$274.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.82 / $40.08 / $53.10	Professional	26	$27.82	$40.08	$53.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.03 / $118.54 / $172.95	Professional	TC	$81.03	$118.54	$172.95