Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $144.54 / $407.38	Facility	26	$43.65	$144.54	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $154.88 / $295.12	Professional		$109.65	$154.88	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $42.66 / $107.15	Professional	26	$30.20	$42.66	$107.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $27.54 / $123.03 / $204.17	Professional	52	$27.54	$123.03	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $107.15 / $251.19	Professional	TC	$81.28	$107.15	$251.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $173.78 / $245.47	Professional		$104.71	$173.78	$245.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $47.86 / $67.61	Professional	26	$27.54	$47.86	$67.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $125.89 / $177.83	Professional	TC	$75.86	$125.89	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $173.78 / $295.12	Professional		$138.04	$173.78	$295.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $47.86 / $89.13	Professional	26	$39.81	$47.86	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $134.90 / $234.42	Professional	TC	$100.00	$134.90	$234.42
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $251.19	Professional		$117.49	$173.78	$251.19
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $190.55 / $363.08	Professional		$151.36	$190.55	$363.08
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $53.70 / $102.33	Professional	26	$42.66	$53.70	$102.33
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $138.04 / $263.03	Professional	TC	$109.65	$138.04	$263.03
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $112.20 / $302.00	Facility	26	$43.65	$112.20	$302.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $158.49 / $295.12	Professional		$123.03	$158.49	$295.12
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $44.67 / $97.72	Professional	26	$33.88	$44.67	$97.72
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $20.42 / $120.23 / $204.17	Professional	52	$20.42	$120.23	$204.17
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $117.49 / $234.42	Professional	TC	$91.20	$117.49	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $186.21 / $354.81	Professional		$128.82	$186.21	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $52.48 / $100.00	Professional	26	$38.02	$52.48	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $131.83 / $257.04	Professional	TC	$91.20	$131.83	$257.04