Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.45 / $71.45 / $71.45	Facility	26	$71.45	$71.45	$71.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $111.87 / $170.31	Professional		$90.76	$111.87	$170.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.28 / $69.73 / $92.92	Professional	26	$62.28	$69.73	$92.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.48 / $36.65 / $77.38	Professional	TC	$28.48	$36.65	$77.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.60 / $141.13 / $269.24	Professional		$101.60	$141.13	$269.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.18 / $85.89 / $147.22	Professional	26	$63.18	$85.89	$147.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.76 / $49.14 / $96.29	Professional	TC	$41.76	$49.14	$96.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.90 / $161.71 / $239.85	Professional		$120.90	$161.71	$239.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.36 / $95.06 / $133.56	Professional	26	$74.36	$95.06	$133.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.29 / $70.18 / $106.29	Professional	TC	$38.29	$70.18	$106.29
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $148.80 / $170.10 / $391.36	Professional		$148.80	$170.10	$391.36
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $73.37 / $84.89 / $199.93	Professional	26	$73.37	$84.89	$199.93
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $55.23 / $55.23 / $150.50	Professional	TC	$55.23	$55.23	$150.50
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $111.87 / $170.31	Professional		$90.76	$111.87	$170.31
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $62.28 / $71.45 / $97.54	Professional	26	$62.28	$71.45	$97.54
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $28.48 / $40.39 / $77.38	Professional	TC	$28.48	$40.39	$77.38
United Facility/Professional Professional Modifier Low / Median / High Price $95.81 / $128.61 / $213.57	Professional		$95.81	$128.61	$213.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.21 / $89.44 / $114.76	Professional	26	$63.21	$89.44	$114.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.34 / $40.04 / $80.72	Professional	TC	$32.34	$40.04	$80.72