Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $421.68 / $507.97 / $991.26	Facility		$421.68	$507.97	$991.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.05 / $33.22 / $35.88	Facility	26	$23.05	$33.22	$35.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $104.54 / $129.09 / $766.77	Facility	TC	$104.54	$129.09	$766.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.46 / $127.59 / $224.50	Professional		$100.46	$127.59	$224.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.17 / $23.05 / $38.57	Professional	26	$21.17	$23.05	$38.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.81 / $104.54 / $168.67	Professional	TC	$101.81	$104.54	$168.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.51 / $129.91 / $227.00	Professional		$114.51	$129.91	$227.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $22.75 / $39.42	Professional	26	$20.05	$22.75	$39.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.45 / $107.16 / $187.58	Professional	TC	$94.45	$107.16	$187.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.83 / $177.48 / $267.92	Professional		$134.83	$177.48	$267.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.98 / $30.73 / $46.34	Professional	26	$22.98	$30.73	$46.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.75 / $150.15 / $223.31	Professional	TC	$105.75	$150.15	$223.31
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $701.25 / $701.25 / $701.25	Facility		$701.25	$701.25	$701.25
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $69.00 / $69.00 / $69.00	Professional		$69.00	$69.00	$69.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $145.91 / $174.83 / $258.99	Professional		$145.91	$174.83	$258.99
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $25.56 / $30.62 / $45.37	Professional	26	$25.56	$30.62	$45.37
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $120.36 / $144.84 / $235.97	Professional	TC	$120.36	$144.84	$235.97
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $346.08 / $601.95 / $898.28	Facility		$346.08	$601.95	$898.28
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $23.05 / $30.63 / $91.50	Facility	26	$23.05	$30.63	$91.50
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $104.54 / $530.16 / $782.33	Facility	TC	$104.54	$530.16	$782.33
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $116.56 / $137.00 / $224.50	Professional		$116.56	$137.00	$224.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $21.17 / $25.11 / $38.57	Professional	26	$21.17	$25.11	$38.57
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $102.26 / $113.83 / $185.93	Professional	TC	$102.26	$113.83	$185.93
United Facility/Professional Professional Modifier Low / Median / High Price $114.08 / $164.68 / $243.76	Professional		$114.08	$164.68	$243.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $31.85 / $41.51	Professional	26	$21.88	$31.85	$41.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.34 / $137.34 / $213.63	Professional	TC	$96.34	$137.34	$213.63