Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.00 / $13.00 / $320.81	Facility	26	$13.00	$13.00	$320.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.87 / $115.56 / $144.94	Professional		$88.87	$115.56	$144.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $12.84 / $17.70	Professional	26	$11.50	$12.84	$17.70
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $40.14 / $44.44 / $46.49	Professional	52	$40.14	$44.44	$46.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.84 / $104.06 / $130.94	Professional	TC	$75.84	$104.06	$130.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.25 / $89.92 / $157.05	Professional		$79.25	$89.92	$157.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $12.85 / $22.25	Professional	26	$11.32	$12.85	$22.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.93 / $77.06 / $134.80	Professional	TC	$67.93	$77.06	$134.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.71 / $125.27 / $182.60	Professional		$95.71	$125.27	$182.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.73 / $17.01 / $26.03	Professional	26	$12.73	$17.01	$26.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.20 / $107.27 / $156.57	Professional	TC	$70.20	$107.27	$156.57
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $100.99 / $121.00 / $179.25	Professional		$100.99	$121.00	$179.25
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $14.43 / $17.29 / $25.61	Professional	26	$14.43	$17.29	$25.61
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $86.56 / $103.71 / $153.63	Professional	TC	$86.56	$103.71	$153.63
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $305.64 / $305.64 / $320.81	Facility	26	$305.64	$305.64	$320.81
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $88.87 / $108.70 / $148.63	Professional		$88.87	$108.70	$148.63
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $13.00 / $19.80	Professional	26	$11.50	$13.00	$19.80
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $44.44 / $44.44 / $49.18	Professional	52	$44.44	$44.44	$49.18
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $75.84 / $97.21 / $131.53	Professional	TC	$75.84	$97.21	$131.53
United Facility/Professional Professional Modifier Low / Median / High Price $86.28 / $121.08 / $168.32	Professional		$86.28	$121.08	$168.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.53 / $17.80 / $23.13	Professional	26	$12.53	$17.80	$23.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.63 / $106.84 / $148.63	Professional	TC	$73.63	$106.84	$148.63