Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.34 / $171.86 / $171.86	Facility	26	$56.34	$171.86	$171.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.55 / $159.06 / $256.18	Professional		$130.55	$159.06	$256.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $49.64 / $75.68	Professional	26	$42.60	$49.64	$75.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.95 / $102.73 / $150.71	Professional	TC	$87.95	$102.73	$150.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.96 / $185.00 / $258.79	Professional		$142.96	$185.00	$258.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.41 / $63.95 / $89.01	Professional	26	$49.41	$63.95	$89.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.54 / $121.05 / $169.77	Professional	TC	$93.54	$121.05	$169.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.94 / $197.01 / $302.82	Professional		$151.94	$197.01	$302.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.62 / $73.23 / $104.24	Professional	26	$46.62	$73.23	$104.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.09 / $134.65 / $198.59	Professional	TC	$95.09	$134.65	$198.59
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $156.04 / $217.15 / $272.45	Professional		$156.04	$217.15	$272.45
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $165.70 / $198.53 / $294.10	Professional		$165.70	$198.53	$294.10
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $58.12 / $69.63 / $103.16	Professional	26	$58.12	$69.63	$103.16
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $107.58 / $128.88 / $190.94	Professional	TC	$107.58	$128.88	$190.94
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $54.37 / $57.31 / $315.48	Facility	26	$54.37	$57.31	$315.48
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $144.69 / $159.06 / $254.51	Professional		$144.69	$159.06	$254.51
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $45.13 / $56.34 / $85.12	Professional	26	$45.13	$56.34	$85.12
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $98.44 / $102.73 / $166.15	Professional	TC	$98.44	$102.73	$166.15
United Facility/Professional Professional Modifier Low / Median / High Price $132.40 / $195.14 / $277.44	Professional		$132.40	$195.14	$277.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.07 / $71.84 / $94.43	Professional	26	$49.07	$71.84	$94.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.33 / $123.29 / $183.01	Professional	TC	$83.33	$123.29	$183.01