Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $87.10 / $87.10	Facility	26	$87.10	$87.10	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $323.59 / $660.69	Professional		$263.03	$323.59	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $64.57 / $87.10	Professional	26	$48.98	$64.57	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $263.03 / $389.05	Professional	TC	$208.93	$263.03	$389.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $436.52 / $575.44	Professional		$302.00	$436.52	$575.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $87.10 / $112.20	Professional	26	$60.26	$87.10	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $346.74 / $457.09	Professional	TC	$245.47	$346.74	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $575.44 / $812.83	Professional		$389.05	$575.44	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $107.15 / $158.49	Professional	26	$79.43	$107.15	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $467.74 / $645.65	Professional	TC	$309.03	$467.74	$645.65
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $457.09 / $870.96	Professional		$389.05	$457.09	$870.96
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $93.33 / $177.83	Professional	26	$77.62	$93.33	$177.83
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $371.54 / $707.95	Professional	TC	$309.03	$371.54	$707.95
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $87.10 / $87.10	Facility	26	$87.10	$87.10	$87.10
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $389.05 / $616.60	Professional		$323.59	$389.05	$616.60
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $75.86 / $123.03	Professional	26	$57.54	$75.86	$123.03
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $316.23 / $489.78	Professional	TC	$257.04	$316.23	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $478.63 / $870.96	Professional		$380.19	$478.63	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $95.50 / $138.04	Professional	26	$75.86	$95.50	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $380.19 / $549.54	Professional	TC	$302.00	$380.19	$549.54