Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.15 / $114.15 / $114.15	Facility	26	$114.15	$114.15	$114.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.10 / $197.12 / $237.47	Professional		$141.10	$197.12	$237.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.92 / $103.13 / $170.38	Professional	26	$90.92	$103.13	$170.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.95 / $88.89 / $109.05	Professional	TC	$26.95	$88.89	$109.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.32 / $189.99 / $270.86	Professional		$142.32	$189.99	$270.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $110.48 / $142.97 / $202.19	Professional	26	$110.48	$142.97	$202.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.44 / $40.64 / $68.67	Professional	TC	$32.44	$40.64	$68.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.24 / $226.60 / $312.16	Professional		$165.24	$226.60	$312.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.84 / $181.85 / $245.28	Professional	26	$129.84	$181.85	$245.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.40 / $53.70 / $88.48	Professional	TC	$35.40	$53.70	$88.48
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $181.37 / $209.85 / $393.72	Professional		$181.37	$209.85	$393.72
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $133.13 / $154.04 / $289.02	Professional	26	$133.13	$154.04	$289.02
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $48.23 / $55.80 / $104.70	Professional	TC	$48.23	$55.80	$104.70
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $141.09 / $199.50 / $318.92	Professional		$141.09	$199.50	$318.92
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $90.92 / $114.15 / $194.52	Professional	26	$90.92	$114.15	$194.52
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.94 / $72.90 / $109.05	Professional	TC	$26.94	$72.90	$109.05
United Facility/Professional Professional Modifier Low / Median / High Price $130.16 / $217.50 / $337.84	Professional		$130.16	$217.50	$337.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.74 / $168.80 / $214.71	Professional	26	$120.74	$168.80	$214.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.55 / $64.54 / $77.87	Professional	TC	$23.55	$64.54	$77.87