Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.59 / $599.54 / $691.02	Facility		$128.59	$599.54	$691.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.64 / $41.64 / $201.36	Facility	26	$41.64	$41.64	$201.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $86.93 / $267.72 / $658.01	Facility	TC	$86.93	$267.72	$658.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.60 / $133.18 / $204.26	Professional		$114.60	$133.18	$204.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $35.96 / $59.70	Professional	26	$31.67	$35.96	$59.70
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $44.10 / $64.30 / $64.30	Professional	52	$44.10	$64.30	$64.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.06 / $98.24 / $126.39	Professional	TC	$79.06	$98.24	$126.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $367.53 / $507.66 / $833.18	Facility		$367.53	$507.66	$833.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.42 / $149.36 / $206.64	Professional		$115.42	$149.36	$206.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.71 / $47.50 / $66.13	Professional	26	$36.71	$47.50	$66.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.70 / $101.86 / $140.53	Professional	TC	$78.70	$101.86	$140.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.76 / $167.45 / $244.24	Professional		$129.76	$167.45	$244.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.22 / $50.79 / $77.17	Professional	26	$35.22	$50.79	$77.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $86.53 / $112.01 / $167.07	Professional	TC	$86.53	$112.01	$167.07
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $489.28 / $489.28 / $489.28	Facility		$489.28	$489.28	$489.28
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $133.13 / $154.04 / $236.31	Professional		$133.13	$154.04	$236.31
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 $90.27 / $108.15 / $176.97	Professional	TC	$90.27	$108.15	$176.97
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $128.59 / $563.54 / $811.31	Facility		$128.59	$563.54	$811.31
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $39.95 / $42.19 / $208.40	Facility	26	$39.95	$42.19	$208.40
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $86.93 / $274.17 / $757.88	Facility	TC	$86.93	$274.17	$757.88
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $119.64 / $133.18 / $204.26	Professional		$119.64	$133.18	$204.26
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $41.64 / $63.39	Professional	26	$31.67	$41.64	$63.39
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $44.10 / $64.30 / $89.69	Professional	52	$44.10	$64.30	$89.69
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $85.32 / $94.30 / $139.34	Professional	TC	$85.32	$94.30	$139.34
United Facility/Professional Professional Modifier Low / Median / High Price $106.81 / $155.43 / $221.52	Professional		$106.81	$155.43	$221.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.40 / $52.24 / $69.89	Professional	26	$33.40	$52.24	$69.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.52 / $106.35 / $158.31	Professional	TC	$70.52	$106.35	$158.31