Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.00 / $132.00 / $132.01	Facility	26	$132.00	$132.00	$132.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $666.97 / $777.87 / $1,115.74	Professional		$666.97	$777.87	$1,115.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.20 / $132.01 / $188.10	Professional	26	$123.20	$132.01	$188.10
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $323.27 / $336.16 / $392.16	Professional	52	$323.27	$336.16	$392.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $534.96 / $654.21 / $927.64	Professional	TC	$534.96	$654.21	$927.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $637.23 / $779.05 / $1,205.63	Professional		$637.23	$779.05	$1,205.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.09 / $149.91 / $229.54	Professional	26	$117.09	$149.91	$229.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $520.13 / $629.14 / $962.74	Professional	TC	$520.13	$629.14	$962.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.38 / $1,026.43 / $1,801.92	Professional		$776.38	$1,026.43	$1,801.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $150.34 / $207.91 / $338.97	Professional	26	$150.34	$207.91	$338.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $618.17 / $839.25 / $1,462.95	Professional	TC	$618.17	$839.25	$1,462.95
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $690.23 / $852.63 / $1,441.27	Professional		$690.23	$852.63	$1,441.27
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $126.84 / $156.68 / $264.85	Professional	26	$126.84	$156.68	$264.85
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $563.40 / $695.96 / $1,176.44	Professional	TC	$563.40	$695.96	$1,176.44
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $666.97 / $777.87 / $1,115.74	Professional		$666.97	$777.87	$1,115.74
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $123.20 / $133.52 / $185.73	Professional	26	$123.20	$133.52	$185.73
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $323.27 / $333.49 / $392.16	Professional	52	$323.27	$333.49	$392.16
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $534.96 / $639.25 / $927.64	Professional	TC	$534.96	$639.25	$927.64
United Facility/Professional Professional Modifier Low / Median / High Price $712.29 / $921.77 / $1,380.68	Professional		$712.29	$921.77	$1,380.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $162.19 / $187.82 / $243.56	Professional	26	$162.19	$187.82	$243.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $571.30 / $734.61 / $1,128.74	Professional	TC	$571.30	$734.61	$1,128.74