Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.74 / $56.74 / $131.76	Facility	26	$56.74	$56.74	$131.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.03 / $174.44 / $266.33	Professional		$148.03	$174.44	$266.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.89 / $49.04 / $72.75	Professional	26	$42.89	$49.04	$72.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.43 / $125.40 / $193.59	Professional	TC	$111.43	$125.40	$193.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.65 / $216.98 / $302.67	Professional		$153.65	$216.98	$302.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.29 / $64.40 / $89.01	Professional	26	$45.29	$64.40	$89.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $108.36 / $152.57 / $213.65	Professional	TC	$108.36	$152.57	$213.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.29 / $222.38 / $370.90	Professional		$188.29	$222.38	$370.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.40 / $75.30 / $110.26	Professional	26	$52.40	$75.30	$110.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.09 / $175.29 / $263.58	Professional	TC	$121.09	$175.29	$263.58
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $138.29 / $155.00 / $176.00	Professional		$138.29	$155.00	$176.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $195.80 / $234.59 / $451.61	Professional		$195.80	$234.59	$451.61
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $57.71 / $69.44 / $125.28	Professional	26	$57.71	$69.44	$125.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $138.09 / $166.17 / $299.77	Professional	TC	$138.09	$166.17	$299.77
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $53.97 / $56.96 / $218.96	Facility	26	$53.97	$56.96	$218.96
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $162.62 / $191.87 / $301.08	Professional		$162.62	$191.87	$301.08
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $44.82 / $56.74 / $87.71	Professional	26	$44.82	$56.74	$87.71
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $118.55 / $135.13 / $213.38	Professional	TC	$118.55	$135.13	$213.38
United Facility/Professional Professional Modifier Low / Median / High Price $171.79 / $254.45 / $426.59	Professional		$171.79	$254.45	$426.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.25 / $69.17 / $118.12	Professional	26	$51.25	$69.17	$118.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.54 / $167.00 / $281.33	Professional	TC	$120.54	$167.00	$281.33