Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.57 / $19.59 / $111.63	Facility	26	$19.57	$19.59	$111.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $65.76 / $100.87	Professional		$54.52	$65.76	$100.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $18.82 / $28.45	Professional	26	$16.39	$18.82	$28.45
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.99 / $32.89 / $34.88	Professional	52	$25.99	$32.89	$34.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.11 / $44.15 / $72.42	Professional	TC	$38.11	$44.15	$72.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.90 / $79.73 / $110.76	Professional		$57.90	$79.73	$110.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.47 / $22.43 / $33.07	Professional	26	$17.47	$22.43	$33.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.43 / $57.31 / $79.61	Professional	TC	$40.43	$57.31	$79.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.45 / $93.43 / $143.88	Professional		$62.45	$93.43	$143.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.85 / $28.53 / $43.25	Professional	26	$20.85	$28.53	$43.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.45 / $67.26 / $105.18	Professional	TC	$49.45	$67.26	$105.18
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $62.71 / $77.47 / $130.94	Professional		$62.71	$77.47	$130.94
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $18.92 / $23.37 / $39.51	Professional	26	$18.92	$23.37	$39.51
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $43.80 / $52.05 / $111.86	Professional	TC	$43.80	$52.05	$111.86
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $111.63	Facility	26	$25.12	$25.12	$111.63
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $67.25 / $113.76	Professional		$54.71	$67.25	$113.76
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $16.82 / $19.63 / $33.97	Professional	26	$16.82	$19.63	$33.97
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $29.10 / $32.89 / $34.88	Professional	52	$29.10	$32.89	$34.88
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $38.11 / $48.28 / $79.79	Professional	TC	$38.11	$48.28	$79.79
United Facility/Professional Professional Modifier Low / Median / High Price $70.25 / $80.31 / $130.94	Professional		$70.25	$80.31	$130.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.51 / $29.52 / $36.58	Professional	26	$21.51	$29.52	$36.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.85 / $58.89 / $143.86	Professional	TC	$47.85	$58.89	$143.86