Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $159.99 / $363.23 / $736.46	Facility		$159.99	$363.23	$736.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.53 / $31.53 / $36.50	Facility	26	$31.53	$31.53	$36.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.84 / $122.93 / $192.58	Professional		$67.84	$122.93	$192.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.78 / $31.53 / $41.05	Professional	26	$23.78	$31.53	$41.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.04 / $91.39 / $151.54	Professional	TC	$44.04	$91.39	$151.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $174.46 / $240.99 / $395.51	Facility		$174.46	$240.99	$395.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.78 / $137.87 / $221.27	Professional		$120.78	$137.87	$221.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.04 / $34.11 / $50.23	Professional	26	$28.04	$34.11	$50.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.75 / $102.39 / $153.82	Professional	TC	$84.75	$102.39	$153.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.37 / $162.60 / $260.70	Professional		$120.37	$162.60	$260.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.79 / $42.24 / $59.11	Professional	26	$32.79	$42.24	$59.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.08 / $122.40 / $201.59	Professional	TC	$84.08	$122.40	$201.59
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $126.27 / $162.63 / $249.48	Professional		$126.27	$162.63	$249.48
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $29.25 / $37.67 / $57.79	Professional	26	$29.25	$37.67	$57.79
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $97.02 / $109.08 / $191.69	Professional	TC	$97.02	$109.08	$191.69
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $132.44 / $363.23 / $890.82	Facility		$132.44	$363.23	$890.82
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $31.53 / $31.96 / $36.50	Facility	26	$31.53	$31.96	$36.50
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $75.17 / $122.93 / $206.33	Professional		$75.17	$122.93	$206.33
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $25.28 / $31.53 / $49.35	Professional	26	$25.28	$31.53	$49.35
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $49.89 / $91.39 / $167.01	Professional	TC	$49.89	$91.39	$167.01
United Facility/Professional Professional Modifier Low / Median / High Price $101.56 / $139.54 / $237.74	Professional		$101.56	$139.54	$237.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.43 / $39.85 / $53.12	Professional	26	$27.43	$39.85	$53.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.48 / $92.08 / $184.62	Professional	TC	$65.48	$92.08	$184.62