Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $134.90 / $134.90	Facility	26	$134.90	$134.90	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $977.24 / $2,754.23	Professional		$758.58	$977.24	$2,754.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $186.21 / $562.34	Professional	26	$117.49	$186.21	$562.34
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $275.42 / $891.25 / $1,479.11	Professional	52	$275.42	$891.25	$1,479.11
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $549.54 / $549.54 / $549.54	Professional	53	$549.54	$549.54	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $616.60 / $758.58 / $1,412.54	Professional	TC	$616.60	$758.58	$1,412.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $912.01 / $1,380.38	Professional		$724.44	$912.01	$1,380.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $144.54 / $218.78	Professional	26	$102.33	$144.54	$218.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $616.60 / $776.25 / $1,174.90	Professional	TC	$616.60	$776.25	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,071.52 / $2,041.74	Professional		$891.25	$1,071.52	$2,041.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $213.80 / $316.23	Professional	26	$131.83	$213.80	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $724.44 / $891.25 / $1,698.24	Professional	TC	$724.44	$891.25	$1,698.24
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,230.27 / $2,290.87	Professional		$977.24	$1,230.27	$2,290.87
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $181.97 / $338.84	Professional	26	$141.25	$181.97	$338.84
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $831.76 / $1,047.13 / $1,949.84	Professional	TC	$831.76	$1,047.13	$1,949.84
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,023.29 / $2,691.53	Professional		$776.25	$1,023.29	$2,691.53
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $186.21 / $549.54	Professional	26	$120.23	$186.21	$549.54
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $1,071.52 / $1,071.52 / $1,479.11	Professional	52	$1,071.52	$1,071.52	$1,479.11
Martin's Point Facility/Professional Professional Modifier 53 Low / Median / High Price $549.54 / $549.54 / $549.54	Professional	53	$549.54	$549.54	$549.54
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $812.83 / $1,905.46	Professional	TC	$645.65	$812.83	$1,905.46
United Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,202.26 / $2,290.87	Professional		$870.96	$1,202.26	$2,290.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $223.87 / $338.84	Professional	26	$131.83	$223.87	$338.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $741.31 / $1,000.00 / $1,659.59	Professional	TC	$741.31	$1,000.00	$1,659.59