Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.39 / $25.39 / $25.39	Facility	26	$25.39	$25.39	$25.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.76 / $134.32 / $218.19	Professional		$116.76	$134.32	$218.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $21.80 / $34.72	Professional	26	$14.49	$21.80	$34.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.81 / $109.25 / $172.15	Professional	TC	$101.81	$109.25	$172.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.39 / $134.32 / $235.90	Professional		$118.39	$134.32	$235.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.00 / $24.96 / $43.87	Professional	26	$22.00	$24.96	$43.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $96.39 / $109.37 / $192.03	Professional	TC	$96.39	$109.37	$192.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.55 / $189.53 / $278.93	Professional		$141.55	$189.53	$278.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.59 / $30.29 / $51.34	Professional	26	$18.59	$30.29	$51.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.85 / $155.02 / $227.59	Professional	TC	$104.85	$155.02	$227.59
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $150.87 / $180.76 / $267.77	Professional		$150.87	$180.76	$267.77
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $28.03 / $33.58 / $49.75	Professional	26	$28.03	$33.58	$49.75
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $122.84 / $142.13 / $218.03	Professional	TC	$122.84	$142.13	$218.03
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $116.76 / $137.91 / $231.89	Professional		$116.76	$137.91	$231.89
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $25.39 / $42.12	Professional	26	$14.49	$25.39	$42.12
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $101.81 / $114.20 / $189.77	Professional	TC	$101.81	$114.20	$189.77
United Facility/Professional Professional Modifier Low / Median / High Price $120.54 / $183.68 / $252.86	Professional		$120.54	$183.68	$252.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.16 / $35.25 / $45.80	Professional	26	$24.16	$35.25	$45.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.80 / $143.66 / $207.06	Professional	TC	$100.80	$143.66	$207.06