Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	26	$125.89	$125.89	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $691.83 / $1,412.54	Professional		$575.44	$691.83	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $154.88 / $457.09	Professional	26	$112.20	$154.88	$457.09
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $257.04 / $269.15 / $275.42	Professional	52	$257.04	$269.15	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $549.54 / $1,023.29	Professional	TC	$457.09	$549.54	$1,023.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $691.83 / $1,288.25	Professional		$436.52	$691.83	$1,288.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $128.82 / $239.88	Professional	26	$83.18	$128.82	$239.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $575.44 / $1,071.52	Professional	TC	$354.81	$575.44	$1,071.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $933.25 / $1,445.44	Professional		$724.44	$933.25	$1,445.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $190.55 / $281.84	Professional	26	$134.90	$190.55	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $758.58 / $1,174.90	Professional	TC	$588.84	$758.58	$1,174.90
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,000.00 / $1,905.46	Professional		$707.95	$1,000.00	$1,905.46
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $177.83 / $338.84	Professional	26	$125.89	$177.83	$338.84
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $831.76 / $1,584.89	Professional	TC	$588.84	$831.76	$1,584.89
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $776.25 / $1,513.56	Professional		$616.60	$776.25	$1,513.56
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $162.18 / $407.38	Professional	26	$117.49	$162.18	$407.38
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $269.15 / $269.15 / $275.42	Professional	52	$269.15	$269.15	$275.42
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $645.65 / $1,258.93	Professional	TC	$489.78	$645.65	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $912.01 / $1,479.11	Professional		$616.60	$912.01	$1,479.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $181.97 / $263.03	Professional	26	$123.03	$181.97	$263.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $724.44 / $1,174.90	Professional	TC	$501.19	$724.44	$1,174.90