Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $198.84 / $198.85 / $198.85	Facility	26	$198.84	$198.85	$198.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.05 / $318.16 / $462.01	Professional		$288.05	$318.16	$462.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $171.18 / $196.59 / $287.54	Professional	26	$171.18	$196.59	$287.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.47 / $119.31 / $174.46	Professional	TC	$112.47	$119.31	$174.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $274.95 / $298.31 / $543.03	Professional		$274.95	$298.31	$543.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $176.66 / $188.95 / $346.54	Professional	26	$176.66	$188.95	$346.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.69 / $109.36 / $196.48	Professional	TC	$97.69	$109.36	$196.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.08 / $390.51 / $653.58	Professional		$90.08	$390.51	$653.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $215.43 / $289.58 / $432.38	Professional	26	$215.43	$289.58	$432.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.75 / $173.75 / $277.95	Professional	TC	$130.75	$173.75	$277.95
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $297.81 / $367.89 / $621.87	Professional		$297.81	$367.89	$621.87
Harvard Pilgrim Facility/Professional Professional Modifier 26 Low / Median / High Price $192.01 / $237.18 / $400.93	Professional	26	$192.01	$237.18	$400.93
Harvard Pilgrim Facility/Professional Professional Modifier TC Low / Median / High Price $105.81 / $130.69 / $220.94	Professional	TC	$105.81	$130.69	$220.94
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $288.05 / $326.44 / $536.07	Professional		$288.05	$326.44	$536.07
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $171.18 / $198.85 / $343.74	Professional	26	$171.18	$198.85	$343.74
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $115.98 / $123.11 / $192.32	Professional	TC	$115.98	$123.11	$192.32
United Facility/Professional Professional Modifier Low / Median / High Price $339.78 / $421.40 / $621.87	Professional		$339.78	$421.40	$621.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $212.37 / $267.55 / $368.24	Professional	26	$212.37	$267.55	$368.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.84 / $154.94 / $220.94	Professional	TC	$128.84	$154.94	$220.94