Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $201.38 / $449.51 / $544.78	Facility		$201.38	$449.51	$544.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.40 / $44.75 / $245.54	Facility	26	$38.40	$44.75	$245.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.05 / $94.71 / $140.90	Professional		$70.05	$94.71	$140.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.44 / $35.02 / $50.20	Professional	26	$30.44	$35.02	$50.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.32 / $164.16 / $229.50	Professional	50	$46.32	$164.16	$229.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.56 / $59.68 / $90.70	Professional	TC	$50.56	$59.68	$90.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $220.22 / $304.19 / $499.24	Facility		$220.22	$304.19	$499.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.65 / $116.02 / $162.13	Professional		$89.65	$116.02	$162.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $43.84 / $61.04	Professional	26	$33.88	$43.84	$61.04
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $134.47 / $174.04 / $243.20	Professional	50	$134.47	$174.04	$243.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.77 / $72.18 / $101.10	Professional	TC	$55.77	$72.18	$101.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.81 / $122.20 / $189.45	Professional		$91.81	$122.20	$189.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.11 / $47.01 / $71.15	Professional	26	$37.11	$47.01	$71.15
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $129.22 / $129.22 / $129.22	Professional	50	$129.22	$129.22	$129.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.67 / $75.40 / $118.30	Professional	TC	$51.67	$75.40	$118.30
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $661.35 / $661.35 / $661.35	Facility		$661.35	$661.35	$661.35
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $73.94 / $115.02 / $180.75	Professional		$73.94	$115.02	$180.75
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $104.04 / $121.14 / $185.83	Professional		$104.04	$121.14	$185.83
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $46.26 / $78.38	Professional	26	$39.97	$46.26	$78.38
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $64.72 / $77.54 / $114.87	Professional	TC	$64.72	$77.54	$114.87
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $99.43 / $375.64 / $605.55	Facility		$99.43	$375.64	$605.55
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $38.40 / $77.92 / $254.18	Facility	26	$38.40	$77.92	$254.18
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $81.01 / $99.43 / $160.50	Professional		$81.01	$99.43	$160.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $30.88 / $38.40 / $60.50	Professional	26	$30.88	$38.40	$60.50
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $46.32 / $115.80 / $229.50	Professional	50	$46.32	$115.80	$229.50
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $51.56 / $61.21 / $99.99	Professional	TC	$51.56	$61.21	$99.99
United Facility/Professional Professional Modifier Low / Median / High Price $82.97 / $121.32 / $205.26	Professional		$82.97	$121.32	$205.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.47 / $48.55 / $64.44	Professional	26	$33.47	$48.55	$64.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.50 / $73.79 / $111.65	Professional	TC	$49.50	$73.79	$111.65