Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $371.54 / $562.34	Facility		$102.33	$371.54	$562.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $131.83 / $316.23	Facility	26	$38.02	$131.83	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $93.33 / $213.80	Professional		$58.88	$93.33	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $39.81 / $87.10	Professional	26	$26.92	$39.81	$87.10
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $177.83 / $630.96	Professional	50	$48.98	$177.83	$630.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $58.88 / $138.04	Professional	TC	$43.65	$58.88	$138.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $302.00 / $302.00	Facility		$245.47	$302.00	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $120.23 / $162.18	Professional		$83.18	$120.23	$162.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $45.71 / $61.66	Professional	26	$30.90	$45.71	$61.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $123.03 / $181.97 / $245.47	Professional	50	$123.03	$181.97	$245.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $74.13 / $100.00	Professional	TC	$52.48	$74.13	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $117.49 / $190.55	Professional		$91.20	$117.49	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $46.77 / $72.44	Professional	26	$32.36	$46.77	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $74.13 / $120.23	Professional	TC	$48.98	$74.13	$120.23
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $181.97	Professional		$74.13	$114.82	$181.97
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $131.83 / $239.88	Professional		$97.72	$131.83	$239.88
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $48.98 / $89.13	Professional	26	$38.02	$48.98	$89.13
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $85.11 / $147.91	Professional	TC	$63.10	$85.11	$147.91
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $371.54 / $562.34	Facility		$100.00	$371.54	$562.34
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $45.71 / $257.04	Facility	26	$38.02	$45.71	$257.04
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $102.33 / $213.80	Professional		$70.79	$102.33	$213.80
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $44.67 / $87.10	Professional	26	$30.90	$44.67	$87.10
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $165.96 / $630.96	Professional	50	$43.65	$165.96	$630.96
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $67.61 / $128.82	Professional	TC	$48.98	$67.61	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $120.23 / $234.42	Professional		$79.43	$120.23	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $47.86 / $87.10	Professional	26	$32.36	$47.86	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $74.13 / $141.25	Professional	TC	$47.86	$74.13	$141.25