Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $165.96	Facility	26	$141.25	$141.25	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $257.04 / $616.60	Professional		$204.17	$257.04	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $154.88 / $380.19	Professional	26	$120.23	$154.88	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $97.72 / $158.49	Professional	TC	$77.62	$97.72	$158.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $416.87	Professional		$169.82	$223.87	$416.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $134.90 / $251.19	Professional	26	$100.00	$134.90	$251.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $89.13 / $165.96	Professional	TC	$72.44	$89.13	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $302.00 / $524.81	Professional		$239.88	$302.00	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $181.97 / $309.03	Professional	26	$147.91	$181.97	$309.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $123.03 / $218.78	Professional	TC	$93.33	$123.03	$218.78
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $316.23 / $630.96	Professional		$165.96	$316.23	$630.96
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $199.53 / $407.38	Professional	26	$138.04	$199.53	$407.38
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $131.83 / $251.19	Professional	TC	$91.20	$131.83	$251.19
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $165.96	Facility	26	$141.25	$141.25	$165.96
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $269.15 / $575.44	Professional		$213.80	$269.15	$575.44
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $165.96 / $371.54	Professional	26	$123.03	$165.96	$371.54
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $107.15 / $199.53	Professional	TC	$87.10	$107.15	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $331.13 / $501.19	Professional		$229.09	$331.13	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $190.55 / $295.12	Professional	26	$138.04	$190.55	$295.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $131.83 / $204.17	Professional	TC	$95.50	$131.83	$204.17