Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.22 / $46.22 / $134.00	Facility	26	$46.22	$46.22	$134.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.58 / $139.77 / $210.95	Professional		$116.58	$139.77	$210.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $39.43 / $59.08	Professional	26	$34.46	$39.43	$59.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.99 / $98.02 / $151.87	Professional	TC	$84.99	$98.02	$151.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.95 / $171.75 / $239.08	Professional		$121.95	$171.75	$239.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.88 / $52.07 / $72.48	Professional	26	$36.88	$52.07	$72.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.07 / $119.68 / $166.58	Professional	TC	$85.07	$119.68	$166.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.10 / $175.16 / $292.91	Professional		$149.10	$175.16	$292.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.17 / $60.86 / $89.16	Professional	26	$42.17	$60.86	$89.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.60 / $137.22 / $206.70	Professional	TC	$94.60	$137.22	$206.70
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $109.76 / $125.00 / $172.00	Professional		$109.76	$125.00	$172.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $155.40 / $187.00 / $337.34	Professional		$155.40	$187.00	$337.34
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $46.99 / $55.13 / $102.01	Professional	26	$46.99	$55.13	$102.01
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $108.41 / $130.44 / $235.34	Professional	TC	$108.41	$130.44	$235.34
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $43.84 / $46.29 / $134.00	Facility	26	$43.84	$46.29	$134.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $130.40 / $152.19 / $238.68	Professional		$130.40	$152.19	$238.68
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $36.00 / $46.22 / $71.25	Professional	26	$36.00	$46.22	$71.25
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $91.66 / $105.98 / $174.37	Professional	TC	$91.66	$105.98	$174.37
United Facility/Professional Professional Modifier Low / Median / High Price $136.41 / $190.99 / $338.37	Professional		$136.41	$190.99	$338.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.86 / $55.64 / $102.01	Professional	26	$41.86	$55.64	$102.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.95 / $130.50 / $235.34	Professional	TC	$85.95	$130.50	$235.34