Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.71 / $35.71 / $59.98	Facility	26	$35.71	$35.71	$59.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.37 / $103.70 / $200.14	Professional		$74.37	$103.70	$200.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $28.91 / $66.53	Professional	26	$24.78	$28.91	$66.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.29 / $69.43 / $90.75	Professional	TC	$18.29	$69.43	$90.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.44 / $72.25 / $102.36	Professional		$55.44	$72.25	$102.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $42.68 / $81.39	Professional	26	$36.15	$42.68	$81.39
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $83.16 / $108.37 / $153.55	Professional	50	$83.16	$108.37	$153.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.09 / $35.29 / $44.22	Professional	TC	$11.09	$35.29	$44.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.13 / $102.95 / $174.97	Professional		$69.13	$102.95	$174.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.70 / $49.26 / $82.22	Professional	26	$34.70	$49.26	$82.22
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $131.31 / $131.31 / $131.31	Professional	50	$131.31	$131.31	$131.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.92 / $44.63 / $124.49	Professional	TC	$14.92	$44.63	$124.49
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $65.95 / $79.37 / $129.30	Professional		$65.95	$79.37	$129.30
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $52.76 / $63.21 / $93.64	Professional	26	$52.76	$63.21	$93.64
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $13.19 / $15.80 / $23.41	Professional	TC	$13.19	$15.80	$23.41
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $35.71 / $59.25 / $59.98	Facility	26	$35.71	$59.25	$59.98
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $60.50 / $88.23 / $146.96	Professional		$60.50	$88.23	$146.96
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $35.72 / $73.98	Professional	26	$24.78	$35.72	$73.98
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $14.93 / $52.50 / $90.75	Professional	TC	$14.93	$52.50	$90.75
United Facility/Professional Professional Modifier Low / Median / High Price $73.70 / $151.13 / $188.91	Professional		$73.70	$151.13	$188.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.10 / $44.68 / $86.27	Professional	26	$31.10	$44.68	$86.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.41 / $104.14 / $123.42	Professional	TC	$23.41	$104.14	$123.42