Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $741.31 / $1,621.81	Professional		$588.84	$741.31	$1,621.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $151.36 / $436.52	Professional	26	$114.82	$151.36	$436.52
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $371.54 / $371.54 / $371.54	Professional	52	$371.54	$371.54	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $588.84 / $1,148.15	Professional	TC	$478.63	$588.84	$1,148.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $724.44 / $1,348.96	Professional		$457.09	$724.44	$1,348.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $134.90 / $251.19	Professional	26	$85.11	$134.90	$251.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $602.56 / $1,122.02	Professional	TC	$371.54	$602.56	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,000.00 / $1,513.56	Professional		$758.58	$1,000.00	$1,513.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $199.53 / $295.12	Professional	26	$138.04	$199.53	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $616.60 / $812.83 / $1,230.27	Professional	TC	$616.60	$812.83	$1,230.27
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,047.13 / $2,041.74	Professional		$741.31	$1,047.13	$2,041.74
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $181.97 / $354.81	Professional	26	$131.83	$181.97	$354.81
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $616.60 / $870.96 / $1,659.59	Professional	TC	$616.60	$870.96	$1,659.59
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $812.83 / $1,621.81	Professional		$660.69	$812.83	$1,621.81
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $162.18 / $389.05	Professional	26	$123.03	$162.18	$389.05
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $371.54 / $371.54 / $371.54	Professional	52	$371.54	$371.54	$371.54
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $691.83 / $1,318.26	Professional	TC	$524.81	$691.83	$1,318.26
United Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $954.99 / $1,548.82	Professional		$645.65	$954.99	$1,548.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $186.21 / $275.42	Professional	26	$128.82	$186.21	$275.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $758.58 / $1,230.27	Professional	TC	$524.81	$758.58	$1,230.27