Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $40.74 / $141.25	Facility	26	$37.15	$40.74	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $263.03	Professional		$85.11	$125.89	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $44.67 / $95.50	Professional	26	$26.92	$44.67	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $93.33 / $181.97	Professional	TC	$61.66	$93.33	$181.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $199.53	Professional		$97.72	$125.89	$199.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $39.81 / $61.66	Professional	26	$30.20	$39.81	$61.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $87.10 / $141.25	Professional	TC	$70.79	$87.10	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $151.36 / $239.88	Professional		$109.65	$151.36	$239.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $47.86 / $72.44	Professional	26	$31.62	$47.86	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $104.71 / $169.82	Professional	TC	$72.44	$104.71	$169.82
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $138.04 / $147.91	Professional		$91.20	$138.04	$147.91
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $165.96 / $302.00	Professional		$123.03	$165.96	$302.00
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $51.29 / $93.33	Professional	26	$38.90	$51.29	$93.33
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $117.49 / $208.93	Professional	TC	$89.13	$117.49	$208.93
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $40.74 / $141.25	Facility	26	$37.15	$40.74	$141.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $147.91 / $263.03	Professional		$100.00	$147.91	$263.03
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $45.71 / $81.28	Professional	26	$30.90	$45.71	$81.28
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $97.72 / $181.97	Professional	TC	$72.44	$97.72	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $295.12	Professional		$102.33	$154.88	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $48.98 / $89.13	Professional	26	$32.36	$48.98	$89.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $104.71 / $194.98	Professional	TC	$69.18	$104.71	$194.98