Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $114.82 / $114.82	Facility	26	$114.82	$114.82	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $151.36 / $398.11	Professional		$117.49	$151.36	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $114.82 / $302.00	Professional	26	$91.20	$114.82	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.02 / $204.17	Professional	TC	$25.70	$38.02	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $204.17 / $234.42	Professional		$138.04	$204.17	$234.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $147.91 / $173.78	Professional	26	$100.00	$147.91	$173.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $51.29 / $63.10	Professional	TC	$34.67	$51.29	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $281.84 / $426.58	Professional		$165.96	$281.84	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $194.98 / $263.03	Professional	26	$128.82	$194.98	$263.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $70.79 / $109.65	Professional	TC	$35.48	$70.79	$109.65
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $218.78 / $416.87	Professional		$181.97	$218.78	$416.87
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $158.49 / $302.00	Professional	26	$131.83	$158.49	$302.00
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $58.88 / $112.20	Professional	TC	$48.98	$58.88	$112.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $199.53 / $457.09	Professional		$141.25	$199.53	$457.09
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $138.04 / $316.23	Professional	26	$95.50	$138.04	$316.23
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $63.10 / $138.04	Professional	TC	$26.92	$63.10	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $223.87 / $416.87	Professional		$128.82	$223.87	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $151.36 / $275.42	Professional	26	$107.15	$151.36	$275.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $64.57 / $112.20	Professional	TC	$23.44	$64.57	$112.20