Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.24 / $41.24 / $48.02	Facility	26	$41.24	$41.24	$48.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.05 / $114.43 / $180.03	Professional		$94.05	$114.43	$180.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.67 / $36.20 / $53.89	Professional	26	$32.67	$36.20	$53.89
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.70 / $198.83 / $291.00	Professional	50	$46.70	$198.83	$291.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.03 / $73.38 / $116.77	Professional	TC	$66.03	$73.38	$116.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.42 / $141.61 / $195.85	Professional		$109.42	$141.61	$195.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.35 / $47.04 / $65.50	Professional	26	$36.35	$47.04	$65.50
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $164.14 / $212.42 / $293.77	Professional	50	$164.14	$212.42	$293.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.06 / $94.55 / $130.35	Professional	TC	$73.06	$94.55	$130.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $149.07 / $231.48	Professional		$111.15	$149.07	$231.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.77 / $50.44 / $76.41	Professional	26	$39.77	$50.44	$76.41
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $157.99 / $157.99 / $157.99	Professional	50	$157.99	$157.99	$157.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.38 / $98.78 / $155.06	Professional	TC	$71.38	$98.78	$155.06
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $84.09 / $145.93 / $223.87	Professional		$84.09	$145.93	$223.87
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $42.87 / $51.36 / $76.09	Professional	26	$42.87	$51.36	$76.09
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $83.26 / $99.75 / $147.78	Professional	TC	$83.26	$99.75	$147.78
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $48.02 / $48.02 / $48.02	Facility	26	$48.02	$48.02	$48.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $98.70 / $121.70 / $193.65	Professional		$98.70	$121.70	$193.65
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $32.67 / $41.24 / $64.93	Professional	26	$32.67	$41.24	$64.93
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $46.70 / $195.93 / $291.00	Professional	50	$46.70	$195.93	$291.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $66.03 / $80.45 / $128.71	Professional	TC	$66.03	$80.45	$128.71
United Facility/Professional Professional Modifier Low / Median / High Price $101.19 / $147.28 / $209.85	Professional		$101.19	$147.28	$209.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.93 / $52.04 / $85.85	Professional	26	$35.93	$52.04	$85.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.26 / $95.18 / $140.63	Professional	TC	$65.26	$95.18	$140.63