Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.22 / $47.23 / $141.49	Facility	26	$47.22	$47.23	$141.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.34 / $170.64 / $203.97	Professional		$122.34	$170.64	$203.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.23 / $59.28 / $67.14	Professional	26	$47.23	$59.28	$67.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $51.40 / $74.16 / $94.68	Professional	52	$51.40	$74.16	$94.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.23 / $112.85 / $138.75	Professional	TC	$69.23	$112.85	$138.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.31 / $123.34 / $179.94	Professional		$95.31	$123.34	$179.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.10 / $55.70 / $82.02	Professional	26	$44.10	$55.70	$82.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.43 / $63.95 / $97.91	Professional	TC	$51.43	$63.95	$97.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.70 / $186.77 / $280.60	Professional		$122.70	$186.77	$280.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.43 / $77.29 / $121.33	Professional	26	$54.43	$77.29	$121.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.73 / $103.69 / $164.00	Professional	TC	$63.73	$103.69	$164.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $53.17 / $118.71 / $210.70	Professional		$53.17	$118.71	$210.70
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $45.19 / $55.83 / $94.37	Professional	26	$45.19	$55.83	$94.37
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $55.71 / $68.81 / $116.33	Professional	TC	$55.71	$68.81	$116.33
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $47.22 / $59.86 / $142.40	Facility	26	$47.22	$59.86	$142.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $113.41 / $138.24 / $203.97	Professional		$113.41	$138.24	$203.97
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $47.22 / $59.07 / $72.26	Professional	26	$47.22	$59.07	$72.26
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $51.40 / $74.16 / $94.68	Professional	52	$51.40	$74.16	$94.68
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $61.88 / $81.88 / $138.75	Professional	TC	$61.88	$81.88	$138.75
United Facility/Professional Professional Modifier Low / Median / High Price $118.77 / $215.37 / $279.18	Professional		$118.77	$215.37	$279.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.44 / $87.06 / $105.07	Professional	26	$50.44	$87.06	$105.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.20 / $139.28 / $174.11	Professional	TC	$80.20	$139.28	$174.11