Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $1,000.00 / $1,380.38	Facility		$234.42	$1,000.00	$1,380.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Facility	26	$40.74	$40.74	$40.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $204.17 / $524.81	Professional		$169.82	$204.17	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $44.67 / $104.71	Professional	26	$33.11	$44.67	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $162.18 / $323.59	Professional	TC	$134.90	$162.18	$323.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $218.78 / $346.74	Professional		$158.49	$218.78	$346.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $46.77 / $70.79	Professional	26	$33.11	$46.77	$70.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $173.78 / $281.84	Professional	TC	$125.89	$173.78	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $275.42 / $407.38	Professional		$199.53	$275.42	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $45.71 / $83.18	Professional	26	$33.88	$45.71	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $218.78 / $331.13	Professional	TC	$141.25	$218.78	$331.13
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $512.86	Professional		$218.78	$288.40	$512.86
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $60.26 / $107.15	Professional	26	$45.71	$60.26	$107.15
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $229.09 / $407.38	Professional	TC	$173.78	$229.09	$407.38
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $1,000.00 / $1,380.38	Facility		$234.42	$1,000.00	$1,380.38
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $245.47 / $478.63	Professional		$177.83	$245.47	$478.63
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $51.29 / $100.00	Professional	26	$34.67	$51.29	$100.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $194.98 / $346.74	Professional	TC	$147.91	$194.98	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $269.15 / $512.86	Professional		$181.97	$269.15	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $56.23 / $104.71	Professional	26	$36.31	$56.23	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $213.80 / $407.38	Professional	TC	$144.54	$213.80	$407.38