Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $41.69 / $41.69	Facility	26	$41.69	$41.69	$41.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $218.78 / $380.19	Professional		$181.97	$218.78	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $39.81 / $83.18	Professional	26	$23.44	$39.81	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $177.83 / $363.08	Professional	TC	$147.91	$177.83	$363.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $380.19	Professional		$169.82	$239.88	$380.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $44.67 / $70.79	Professional	26	$32.36	$44.67	$70.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $194.98 / $309.03	Professional	TC	$138.04	$194.98	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $288.40 / $446.68	Professional		$204.17	$288.40	$446.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $44.67 / $83.18	Professional	26	$26.30	$44.67	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $245.47 / $363.08	Professional	TC	$154.88	$245.47	$363.08
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $323.59 / $562.34	Professional		$239.88	$323.59	$562.34
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $60.26 / $104.71	Professional	26	$44.67	$60.26	$104.71
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $263.03 / $467.74	Professional	TC	$194.98	$263.03	$467.74
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $263.03 / $562.34	Professional		$181.97	$263.03	$562.34
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $46.77 / $112.20	Professional	26	$30.20	$46.77	$112.20
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $218.78 / $446.68	Professional	TC	$151.36	$218.78	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $295.12 / $562.34	Professional		$199.53	$295.12	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $56.23 / $104.71	Professional	26	$33.11	$56.23	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $234.42 / $457.09	Professional	TC	$162.18	$234.42	$457.09