Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.65 / $58.65 / $58.65	Professional		$58.65	$58.65	$58.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.84 / $21.84 / $21.84	Professional	26	$21.84	$21.84	$21.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.81 / $36.81 / $57.06	Professional	TC	$36.81	$36.81	$57.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.07 / $112.28 / $199.12	Professional		$29.07	$112.28	$199.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.24 / $40.34 / $47.04	Professional	26	$10.24	$40.34	$47.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $71.94 / $104.90	Professional	TC	$18.82	$71.94	$104.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $76.59 / $120.66	Professional		$35.74	$76.59	$120.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.94 / $26.99 / $58.30	Professional	26	$15.94	$26.99	$58.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.92 / $53.70 / $107.16	Professional	TC	$28.92	$53.70	$107.16
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $103.05 / $123.66 / $223.70	Professional		$103.05	$123.66	$223.70
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $30.92 / $37.10 / $67.12	Professional	26	$30.92	$37.10	$67.12
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $72.14 / $86.57 / $156.60	Professional	TC	$72.14	$86.57	$156.60
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $58.65 / $58.65 / $74.98	Professional		$58.65	$58.65	$74.98
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $21.84 / $21.84 / $23.47	Professional	26	$21.84	$21.84	$23.47
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $36.81 / $51.51 / $57.06	Professional	TC	$36.81	$51.51	$57.06
United Facility/Professional Professional Modifier Low / Median / High Price $67.45 / $99.06 / $182.90	Professional		$67.45	$99.06	$182.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.17 / $39.44 / $65.53	Professional	26	$26.17	$39.44	$65.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.21 / $51.91 / $110.46	Professional	TC	$33.21	$51.91	$110.46