Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.43 / $834.80 / $913.98	Facility		$151.43	$834.80	$913.98
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.80 / $22.80 / $22.80	Facility	26	$22.80	$22.80	$22.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.37 / $178.25 / $223.25	Professional		$138.37	$178.25	$223.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.03 / $22.80 / $31.95	Professional	26	$21.03	$22.80	$31.95
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $62.47 / $69.19 / $71.86	Professional	52	$62.47	$69.19	$71.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $115.57 / $157.09 / $197.70	Professional	TC	$115.57	$157.09	$197.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.83 / $142.76 / $248.61	Professional		$125.83	$142.76	$248.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $23.12 / $40.68	Professional	26	$20.38	$23.12	$40.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $105.45 / $119.64 / $207.92	Professional	TC	$105.45	$119.64	$207.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.87 / $194.06 / $285.89	Professional		$149.87	$194.06	$285.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.99 / $30.64 / $47.06	Professional	26	$22.99	$30.64	$47.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.31 / $166.77 / $238.84	Professional	TC	$109.31	$166.77	$238.84
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $160.35 / $192.12 / $284.61	Professional		$160.35	$192.12	$284.61
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $25.97 / $31.11 / $46.09	Professional	26	$25.97	$31.11	$46.09
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $134.38 / $161.00 / $238.51	Professional	TC	$134.38	$161.00	$238.51
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $268.45 / $580.28 / $901.60	Facility		$268.45	$580.28	$901.60
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $138.37 / $168.80 / $235.21	Professional		$138.37	$168.80	$235.21
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $21.17 / $22.81 / $38.74	Professional	26	$21.17	$22.81	$38.74
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $69.19 / $69.19 / $76.34	Professional	52	$69.19	$69.19	$76.34
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $115.57 / $146.75 / $204.22	Professional	TC	$115.57	$146.75	$204.22
United Facility/Professional Professional Modifier Low / Median / High Price $123.66 / $188.69 / $266.16	Professional		$123.66	$188.69	$266.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.70 / $31.70 / $42.17	Professional	26	$21.70	$31.70	$42.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.22 / $164.94 / $223.99	Professional	TC	$112.22	$164.94	$223.99