Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.39 / $49.89 / $303.10	Facility	26	$43.39	$49.89	$303.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.73 / $147.08 / $229.39	Professional		$124.73	$147.08	$229.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.71 / $37.33 / $55.98	Professional	26	$32.71	$37.33	$55.98
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $119.66 / $170.88 / $212.90	Professional	52	$119.66	$170.88	$212.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.32 / $103.57 / $160.22	Professional	TC	$87.32	$103.57	$160.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.53 / $174.95 / $244.16	Professional		$124.53	$174.95	$244.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.93 / $48.88 / $68.04	Professional	26	$34.93	$48.88	$68.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.60 / $126.07 / $176.13	Professional	TC	$89.60	$126.07	$176.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.60 / $179.68 / $299.05	Professional		$151.60	$179.68	$299.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.86 / $57.04 / $83.61	Professional	26	$39.86	$57.04	$83.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.04 / $144.94 / $217.76	Professional	TC	$100.04	$144.94	$217.76
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $112.08 / $161.88 / $252.15	Professional		$112.08	$161.88	$252.15
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $158.69 / $190.97 / $344.51	Professional		$158.69	$190.97	$344.51
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $44.52 / $53.57 / $96.64	Professional	26	$44.52	$53.57	$96.64
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $114.18 / $137.40 / $247.86	Professional	TC	$114.18	$137.40	$247.86
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $43.39 / $112.55 / $303.10	Facility	26	$43.39	$112.55	$303.10
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $133.90 / $155.44 / $244.06	Professional		$133.90	$155.44	$244.06
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $34.17 / $43.39 / $67.45	Professional	26	$34.17	$43.39	$67.45
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $119.66 / $170.88 / $212.90	Professional	52	$119.66	$170.88	$212.90
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $98.28 / $112.04 / $176.59	Professional	TC	$98.28	$112.04	$176.59
United Facility/Professional Professional Modifier Low / Median / High Price $153.24 / $224.49 / $323.60	Professional		$153.24	$224.49	$323.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.34 / $52.71 / $90.35	Professional	26	$39.34	$52.71	$90.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.88 / $141.78 / $249.10	Professional	TC	$90.88	$141.78	$249.10