Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.43 / $113.43 / $113.43	Facility	26	$113.43	$113.43	$113.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.99 / $199.15 / $283.95	Professional		$175.99	$199.15	$283.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.29 / $110.56 / $162.55	Professional	26	$96.29	$110.56	$162.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.70 / $87.67 / $121.40	Professional	TC	$79.70	$87.67	$121.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.88 / $184.31 / $333.82	Professional		$167.88	$184.31	$333.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.95 / $107.63 / $196.48	Professional	26	$99.95	$107.63	$196.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.93 / $81.62 / $137.34	Professional	TC	$67.93	$81.62	$137.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.08 / $237.88 / $403.29	Professional		$90.08	$237.88	$403.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.15 / $165.19 / $245.67	Professional	26	$121.15	$165.19	$245.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.46 / $126.74 / $204.83	Professional	TC	$91.46	$126.74	$204.83
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $181.84 / $224.63 / $379.70	Professional		$181.84	$224.63	$379.70
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $108.26 / $133.74 / $226.07	Professional	26	$108.26	$133.74	$226.07
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $73.58 / $90.89 / $153.63	Professional	TC	$73.58	$90.89	$153.63
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $177.88 / $200.46 / $327.98	Professional		$177.88	$200.46	$327.98
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $98.75 / $113.43 / $194.16	Professional	26	$98.75	$113.43	$194.16
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $79.70 / $87.67 / $133.82	Professional	TC	$79.70	$87.67	$133.82
United Facility/Professional Professional Modifier Low / Median / High Price $213.93 / $275.39 / $379.70	Professional		$213.93	$275.39	$379.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $121.14 / $152.44 / $211.73	Professional	26	$121.14	$152.44	$211.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.94 / $117.69 / $148.19	Professional	TC	$92.94	$117.69	$148.19