Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.21 / $39.21 / $140.91	Facility	26	$39.21	$39.21	$140.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.34 / $138.79 / $218.67	Professional		$113.34	$138.79	$218.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $34.70 / $56.19	Professional	26	$29.75	$34.70	$56.19
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $47.66 / $63.65 / $69.97	Professional	52	$47.66	$63.65	$69.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.59 / $100.70 / $147.24	Professional	TC	$83.59	$100.70	$147.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.45 / $138.18 / $227.63	Professional		$117.45	$138.18	$227.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.79 / $39.77 / $61.68	Professional	26	$33.79	$39.77	$61.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.65 / $98.42 / $165.95	Professional	TC	$83.65	$98.42	$165.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.75 / $169.47 / $269.74	Professional		$111.75	$169.47	$269.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.96 / $51.04 / $72.65	Professional	26	$32.96	$51.04	$72.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.69 / $124.52 / $197.08	Professional	TC	$77.69	$124.52	$197.08
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $107.00 / $171.27 / $239.25	Professional		$107.00	$171.27	$239.25
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $145.51 / $178.60 / $285.27	Professional		$145.51	$178.60	$285.27
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $40.40 / $48.40 / $71.70	Professional	26	$40.40	$48.40	$71.70
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $105.11 / $125.93 / $186.56	Professional	TC	$105.11	$125.93	$186.56
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $37.76 / $39.81 / $140.91	Facility	26	$37.76	$39.81	$140.91
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $125.97 / $139.93 / $223.68	Professional		$125.97	$139.93	$223.68
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $31.55 / $39.21 / $59.47	Professional	26	$31.55	$39.21	$59.47
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $47.66 / $69.97 / $111.87	Professional	52	$47.66	$69.97	$111.87
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $93.56 / $100.70 / $162.31	Professional	TC	$93.56	$100.70	$162.31
United Facility/Professional Professional Modifier Low / Median / High Price $110.36 / $167.13 / $258.27	Professional		$110.36	$167.13	$258.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $49.21 / $79.20	Professional	26	$34.15	$49.21	$79.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.68 / $121.63 / $186.56	Professional	TC	$81.68	$121.63	$186.56