Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $57.54 / $218.78	Facility	26	$53.70	$57.54	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $398.11	Professional		$134.90	$190.55	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $50.12 / $117.49	Professional	26	$36.31	$50.12	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $123.03 / $295.12	Professional	TC	$95.50	$123.03	$295.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $218.78 / $302.00	Professional		$128.82	$218.78	$302.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $63.10 / $89.13	Professional	26	$36.31	$63.10	$89.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $151.36 / $213.80	Professional	TC	$93.33	$151.36	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $218.78 / $363.08	Professional		$173.78	$218.78	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $63.10 / $117.49	Professional	26	$52.48	$63.10	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $162.18 / $281.84	Professional	TC	$120.23	$162.18	$281.84
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $154.88 / $177.83	Professional		$138.04	$154.88	$177.83
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $239.88 / $446.68	Professional		$190.55	$239.88	$446.68
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $70.79 / $134.90	Professional	26	$56.23	$70.79	$134.90
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $169.82 / $316.23	Professional	TC	$134.90	$169.82	$316.23
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $57.54 / $218.78	Facility	26	$53.70	$57.54	$218.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $204.17 / $380.19	Professional		$151.36	$204.17	$380.19
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $56.23 / $117.49	Professional	26	$43.65	$56.23	$117.49
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $30.20 / $30.20	Professional	52	$30.20	$30.20	$30.20
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $141.25 / $295.12	Professional	TC	$109.65	$141.25	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $229.09 / $446.68	Professional		$158.49	$229.09	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $69.18 / $128.82	Professional	26	$48.98	$69.18	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $162.18 / $309.03	Professional	TC	$109.65	$162.18	$309.03