Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.46 / $127.11 / $803.05	Facility		$124.46	$127.11	$803.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.54 / $69.34 / $69.34	Facility	26	$66.54	$69.34	$69.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.08 / $199.83 / $623.30	Professional		$62.08	$199.83	$623.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.40 / $74.81 / $218.77	Professional	26	$34.40	$74.81	$218.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.28 / $57.92 / $200.00	Professional	TC	$26.28	$57.92	$200.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,410.00 / $6,273.00 / $7,714.00	Facility		$5,410.00	$6,273.00	$7,714.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.02 / $120.43 / $487.10	Professional		$58.02	$120.43	$487.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.77 / $66.87 / $186.77	Professional	26	$32.77	$66.87	$186.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.54 / $51.19 / $300.32	Professional	TC	$25.54	$51.19	$300.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $72.66	Facility		$50.00	$50.00	$72.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $233.30 / $396.59	Professional		$88.83	$233.30	$396.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.58 / $112.38 / $141.69	Professional	26	$48.58	$112.38	$141.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.29 / $106.57 / $261.94	Professional	TC	$38.29	$106.57	$261.94
ConnectiCare Facility/Professional Facility Modifier Low / Median / High Price $1,005.87 / $1,058.07 / $1,677.00	Facility		$1,005.87	$1,058.07	$1,677.00
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $106.30 / $278.31	Professional		$74.36	$106.30	$278.31
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $41.65 / $59.53 / $100.77	Professional	26	$41.65	$59.53	$100.77
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $32.72 / $46.78 / $177.54	Professional	TC	$32.72	$46.78	$177.54
Health New England Facility/Professional Professional Modifier Low / Median / High Price $49.01 / $58.02 / $239.61	Professional		$49.01	$58.02	$239.61
Health New England Facility/Professional Professional Modifier 26 Low / Median / High Price $11.47 / $27.97 / $55.94	Professional	26	$11.47	$27.97	$55.94
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.00 / $3,978.00 / $6,535.00	Facility		$1,380.00	$3,978.00	$6,535.00
United Facility/Professional Professional Modifier Low / Median / High Price $69.29 / $134.86 / $272.62	Professional		$69.29	$134.86	$272.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.72 / $68.06 / $115.94	Professional	26	$34.72	$68.06	$115.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.32 / $56.69 / $165.94	Professional	TC	$27.32	$56.69	$165.94