Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.95 / $36.95 / $57.86	Facility	26	$36.95	$36.95	$57.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.34 / $148.93 / $167.15	Professional		$145.34	$148.93	$167.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.95 / $48.52 / $52.49	Professional	26	$36.95	$48.52	$52.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.82 / $111.99 / $130.05	Professional	TC	$96.82	$111.99	$130.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.09 / $80.39 / $338.27	Professional		$73.09	$80.39	$338.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.44 / $21.84 / $78.84	Professional	26	$17.44	$21.84	$78.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.65 / $55.65 / $259.42	Professional	TC	$55.65	$55.65	$259.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.44 / $170.19 / $340.69	Professional		$71.44	$170.19	$340.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $40.13 / $99.20	Professional	26	$28.14	$40.13	$99.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.17 / $130.05 / $236.43	Professional	TC	$82.17	$130.05	$236.43
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $215.17 / $257.80 / $381.91	Professional		$215.17	$257.80	$381.91
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $51.11 / $61.23 / $90.72	Professional	26	$51.11	$61.23	$90.72
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $164.06 / $196.56 / $291.19	Professional	TC	$164.06	$196.56	$291.19
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $57.86 / $57.86 / $57.86	Facility	26	$57.86	$57.86	$57.86
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $148.84 / $164.35 / $314.82	Professional		$148.84	$164.35	$314.82
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $36.95 / $49.68 / $92.29	Professional	26	$36.95	$49.68	$92.29
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $99.15 / $113.08 / $250.03	Professional	TC	$99.15	$113.08	$250.03
United Facility/Professional Professional Modifier Low / Median / High Price $107.11 / $181.90 / $290.45	Professional		$107.11	$181.90	$290.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $45.67 / $77.81	Professional	26	$24.78	$45.67	$77.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.33 / $125.60 / $212.64	Professional	TC	$82.33	$125.60	$212.64