Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $1,412.54 / $2,570.40	Facility		$512.86	$1,412.54	$2,570.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $141.25 / $1,479.11	Facility	26	$83.18	$141.25	$1,479.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $295.12 / $724.44	Professional		$173.78	$295.12	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $74.13 / $199.53	Professional	26	$63.10	$74.13	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $173.78 / $363.08	Professional	TC	$131.83	$173.78	$363.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $575.44	Professional		$194.98	$295.12	$575.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $102.33 / $199.53	Professional	26	$66.07	$102.33	$199.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $190.55 / $380.19	Professional	TC	$128.82	$190.55	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $316.23 / $478.63	Professional		$245.47	$316.23	$478.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $102.33 / $151.36	Professional	26	$69.18	$102.33	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $213.80 / $323.59	Professional	TC	$138.04	$213.80	$323.59
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $3,311.31	Facility		$2,398.83	$2,398.83	$3,311.31
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $316.23 / $562.34	Professional		$239.88	$316.23	$562.34
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $109.65 / $190.55	Professional	26	$81.28	$109.65	$190.55
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $208.93 / $371.54	Professional	TC	$154.88	$208.93	$371.54
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $1,621.81 / $2,691.53	Facility		$478.63	$1,621.81	$2,691.53
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $112.20 / $1,479.11	Facility	26	$83.18	$112.20	$1,479.11
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $660.69	Professional		$194.98	$295.12	$660.69
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $87.10 / $199.53	Professional	26	$64.57	$87.10	$199.53
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $177.83 / $354.81	Professional	TC	$144.54	$177.83	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $562.34	Professional		$199.53	$309.03	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $95.50 / $190.55	Professional	26	$67.61	$95.50	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $218.78 / $363.08	Professional	TC	$128.82	$218.78	$363.08