Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.89 / $12.89 / $97.78	Facility	26	$12.89	$12.89	$97.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.63 / $56.12 / $95.83	Professional		$52.63	$56.12	$95.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.24 / $12.89 / $18.12	Professional	26	$11.24	$12.89	$18.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $27.10 / $27.99 / $30.29	Professional	52	$27.10	$27.99	$30.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.39 / $43.66 / $77.70	Professional	TC	$41.39	$43.66	$77.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.83 / $73.54 / $116.62	Professional		$56.83	$73.54	$116.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.35 / $15.98 / $24.01	Professional	26	$12.35	$15.98	$24.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.91 / $56.83 / $92.61	Professional	TC	$43.91	$56.83	$92.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.77 / $77.76 / $128.63	Professional		$57.77	$77.76	$128.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $17.52 / $26.92	Professional	26	$13.18	$17.52	$26.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.58 / $61.58 / $97.00	Professional	TC	$44.58	$61.58	$97.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $62.95 / $81.06 / $152.11	Professional		$62.95	$81.06	$152.11
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $16.70 / $33.28	Professional	26	$12.96	$16.70	$33.28
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $49.99 / $64.39 / $128.36	Professional	TC	$49.99	$64.39	$128.36
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.89 / $16.46 / $100.98	Facility	26	$12.89	$16.46	$100.98
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $52.67 / $60.58 / $95.83	Professional		$52.67	$60.58	$95.83
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $12.98 / $18.12	Professional	26	$11.69	$12.98	$18.12
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $27.10 / $27.99 / $30.29	Professional	52	$27.10	$27.99	$30.29
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $41.39 / $47.72 / $77.70	Professional	TC	$41.39	$47.72	$77.70
United Facility/Professional Professional Modifier Low / Median / High Price $46.33 / $71.83 / $114.51	Professional		$46.33	$71.83	$114.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.74 / $17.46 / $27.19	Professional	26	$10.74	$17.46	$27.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.83 / $57.62 / $90.90	Professional	TC	$41.83	$57.62	$90.90