Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.48 / $661.25 / $933.39	Facility		$103.48	$661.25	$933.39
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.88 / $55.96 / $61.03	Facility	26	$38.88	$55.96	$61.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $70.31 / $230.82 / $771.94	Facility	TC	$70.31	$230.82	$771.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.65 / $107.68 / $186.30	Professional		$92.65	$107.68	$186.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $29.46 / $48.78	Professional	26	$25.26	$29.46	$48.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.13 / $77.23 / $102.30	Professional	TC	$64.13	$77.23	$102.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $288.86 / $399.00 / $654.84	Facility		$288.86	$399.00	$654.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.18 / $120.59 / $165.95	Professional		$93.18	$120.59	$165.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.64 / $38.36 / $52.14	Professional	26	$29.64	$38.36	$52.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.53 / $82.22 / $113.80	Professional	TC	$63.53	$82.22	$113.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.52 / $133.00 / $196.93	Professional		$94.52	$133.00	$196.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.40 / $40.36 / $62.12	Professional	26	$28.40	$40.36	$62.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.12 / $86.52 / $134.80	Professional	TC	$66.12	$86.52	$134.80
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $606.10 / $606.10 / $606.10	Facility		$606.10	$606.10	$606.10
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $73.08 / $100.92 / $135.00	Professional		$73.08	$100.92	$135.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $107.17 / $128.40 / $190.22	Professional		$107.17	$128.40	$190.22
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $34.21 / $40.99 / $60.72	Professional	26	$34.21	$40.99	$60.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $72.95 / $87.41 / $129.50	Professional	TC	$72.95	$87.41	$129.50
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $116.64 / $519.75 / $890.95	Facility		$116.64	$519.75	$890.95
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $33.14 / $48.95 / $164.01	Facility	26	$33.14	$48.95	$164.01
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $70.31 / $235.20 / $771.94	Facility	TC	$70.31	$235.20	$771.94
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $96.70 / $107.68 / $184.77	Professional		$96.70	$107.68	$184.77
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $26.18 / $33.14 / $51.87	Professional	26	$26.18	$33.14	$51.87
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $69.39 / $76.29 / $112.76	Professional	TC	$69.39	$76.29	$112.76
United Facility/Professional Professional Modifier Low / Median / High Price $85.96 / $125.38 / $177.91	Professional		$85.96	$125.38	$177.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.91 / $42.12 / $55.14	Professional	26	$28.91	$42.12	$55.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.05 / $83.26 / $146.41	Professional	TC	$57.05	$83.26	$146.41