Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $147.91	Professional		$93.33	$120.23	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.14 / $18.20	Professional	26	$12.88	$15.14	$18.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $102.33 / $131.83	Professional	TC	$77.62	$102.33	$131.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $251.19	Professional		$128.82	$173.78	$251.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $19.50 / $28.18	Professional	26	$14.79	$19.50	$28.18
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $190.55 / $263.03 / $380.19	Professional	50	$190.55	$263.03	$380.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $141.25 / $223.87	Professional	TC	$114.82	$141.25	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $147.91 / $257.04	Professional		$93.33	$147.91	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $18.62 / $33.11	Professional	26	$12.30	$18.62	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $138.04 / $229.09	Professional	TC	$77.62	$138.04	$229.09
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $165.96 / $263.03	Professional		$109.65	$165.96	$263.03
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $18.20 / $31.62	Professional	26	$12.30	$18.20	$31.62
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $147.91 / $245.47	Professional	TC	$97.72	$147.91	$245.47
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $114.82 / $147.91	Professional		$93.33	$114.82	$147.91
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.14 / $22.91	Professional	26	$12.88	$15.14	$22.91
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $100.00 / $131.83	Professional	TC	$77.62	$100.00	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $138.04 / $239.88	Professional		$89.13	$138.04	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $18.20 / $29.51	Professional	26	$13.18	$18.20	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $117.49 / $229.09	Professional	TC	$81.28	$117.49	$229.09