Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $77.62 / $154.88	Facility		$22.39	$77.62	$154.88
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $50.12 / $109.65 / $288.40	Facility	25	$50.12	$109.65	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $51.29 / $107.15	Professional		$26.92	$51.29	$107.15
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $30.20 / $57.54 / $120.23	Professional	25	$30.20	$57.54	$120.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $87.10	Professional		$30.90	$51.29	$87.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $54.95 / $190.55	Facility		$39.81	$54.95	$190.55
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $64.57 / $64.57 / $64.57	Facility	22	$64.57	$64.57	$64.57
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $33.88 / $33.88 / $33.88	Facility	62	$33.88	$33.88	$33.88
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $5.37 / $5.37 / $5.37	Facility	AS	$5.37	$5.37	$5.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $47.86 / $100.00	Professional		$28.84	$47.86	$100.00
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $87.10 / $112.20	Professional		$57.54	$87.10	$112.20
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $72.44 / $144.54	Professional		$38.02	$72.44	$144.54
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $75.86 / $154.88	Facility		$34.67	$75.86	$154.88
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $79.43 / $114.82 / $288.40	Facility	25	$79.43	$114.82	$288.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $47.86 / $100.00	Professional		$26.92	$47.86	$100.00
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $33.11 / $58.88 / $131.83	Professional	25	$33.11	$58.88	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $54.95 / $104.71	Professional		$27.54	$54.95	$104.71