Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.48 / $167.48 / $167.48	Facility	26	$167.48	$167.48	$167.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.78 / $274.87 / $394.79	Professional		$248.78	$274.87	$394.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.25 / $165.65 / $242.34	Professional	26	$144.25	$165.65	$242.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.53 / $107.39 / $152.46	Professional	TC	$104.53	$107.39	$152.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.84 / $257.82 / $470.53	Professional		$234.84	$257.82	$470.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $148.84 / $159.19 / $293.13	Professional	26	$148.84	$159.19	$293.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.39 / $98.63 / $177.40	Professional	TC	$85.39	$98.63	$177.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.08 / $336.99 / $565.07	Professional		$90.08	$336.99	$565.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $181.48 / $243.91 / $364.72	Professional	26	$181.48	$243.91	$364.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $118.03 / $156.38 / $248.57	Professional	TC	$118.03	$156.38	$248.57
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $254.37 / $302.25 / $531.16	Professional		$254.37	$302.25	$531.16
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $161.87 / $199.96 / $338.01	Professional	26	$161.87	$199.96	$338.01
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $92.50 / $114.26 / $193.14	Professional	TC	$92.50	$114.26	$193.14
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $248.78 / $280.87 / $469.26	Professional		$248.78	$280.87	$469.26
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $144.25 / $167.48 / $289.70	Professional	26	$144.25	$167.48	$289.70
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $103.76 / $113.73 / $197.16	Professional	TC	$103.76	$113.73	$197.16
United Facility/Professional Professional Modifier Low / Median / High Price $303.99 / $401.62 / $502.72	Professional		$303.99	$401.62	$502.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $178.86 / $226.04 / $311.47	Professional	26	$178.86	$226.04	$311.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.13 / $141.61 / $191.25	Professional	TC	$108.13	$141.61	$191.25