Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $501.19 / $812.83	Facility		$104.71	$501.19	$812.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $51.29 / $162.18	Facility	26	$33.11	$51.29	$162.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $70.79 / $234.42 / $741.31	Facility	TC	$70.79	$234.42	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $112.20 / $218.78	Professional		$75.86	$112.20	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $35.48 / $67.61	Professional	26	$23.99	$35.48	$67.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $79.43 / $154.88	Professional	TC	$50.12	$79.43	$154.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $398.11 / $398.11	Facility		$316.23	$398.11	$398.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $177.83	Professional		$81.28	$123.03	$177.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $39.81 / $52.48	Professional	26	$26.30	$39.81	$52.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $83.18 / $120.23	Professional	TC	$57.54	$83.18	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $204.17	Professional		$91.20	$131.83	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $40.74 / $61.66	Professional	26	$27.54	$40.74	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $85.11 / $138.04	Professional	TC	$64.57	$85.11	$138.04
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Facility		$602.56	$602.56	$602.56
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $134.90	Professional		$72.44	$100.00	$134.90
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $138.04 / $245.47	Professional		$104.71	$138.04	$245.47
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $43.65 / $77.62	Professional	26	$33.11	$43.65	$77.62
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $93.33 / $165.96	Professional	TC	$70.79	$93.33	$165.96
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $524.81 / $776.25	Facility		$104.71	$524.81	$776.25
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $48.98 / $162.18	Facility	26	$33.11	$48.98	$162.18
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $70.79 / $234.42 / $776.25	Facility	TC	$70.79	$234.42	$776.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $117.49 / $218.78	Professional		$83.18	$117.49	$218.78
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $38.90 / $67.61	Professional	26	$26.30	$38.90	$67.61
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $81.28 / $154.88	Professional	TC	$56.23	$81.28	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $128.82 / $245.47	Professional		$85.11	$128.82	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $41.69 / $75.86	Professional	26	$27.54	$41.69	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $87.10 / $162.18	Professional	TC	$57.54	$87.10	$162.18