Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.78 / $48.81 / $53.70	Facility	26	$42.78	$48.81	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.35 / $31.56 / $105.49	Professional		$26.35	$31.56	$105.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $20.03 / $50.69	Professional	26	$17.17	$20.03	$50.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $11.21 / $54.79	Professional	TC	$9.18	$11.21	$54.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.43 / $66.87 / $120.82	Professional		$62.43	$66.87	$120.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.12 / $33.20 / $61.68	Professional	26	$28.12	$33.20	$61.68
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $93.64 / $100.30 / $181.23	Professional	50	$93.64	$100.30	$181.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.41 / $36.96 / $59.13	Professional	TC	$31.41	$36.96	$59.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.64 / $79.48 / $124.73	Professional		$40.64	$79.48	$124.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.69 / $37.54 / $62.73	Professional	26	$24.69	$37.54	$62.73
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $84.74 / $84.74 / $84.74	Professional	50	$84.74	$84.74	$84.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.96 / $43.57 / $74.03	Professional	TC	$13.96	$43.57	$74.03
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $79.05 / $92.04 / $141.19	Professional		$79.05	$92.04	$141.19
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 $39.15 / $45.31 / $76.77	Professional	TC	$39.15	$45.31	$76.77
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $27.62 / $45.21 / $53.70	Facility	26	$27.62	$45.21	$53.70
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $27.35 / $64.75 / $111.16	Professional		$27.35	$64.75	$111.16
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $27.63 / $57.24	Professional	26	$17.80	$27.63	$57.24
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $37.11 / $59.46	Professional	TC	$9.18	$37.11	$59.46
United Facility/Professional Professional Modifier Low / Median / High Price $46.07 / $54.20 / $128.81	Professional		$46.07	$54.20	$128.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $35.02 / $65.14	Professional	26	$24.07	$35.02	$65.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.59 / $17.70 / $63.67	Professional	TC	$14.59	$17.70	$63.67