Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $725.68 / $4,450.00 / $8,031.00	Facility		$725.68	$4,450.00	$8,031.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.54 / $71.54 / $73.20	Facility	26	$71.54	$71.54	$73.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.13 / $202.84 / $400.32	Professional		$140.13	$202.84	$400.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.96 / $71.54 / $164.22	Professional	26	$41.96	$71.54	$164.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.17 / $131.30 / $240.16	Professional	TC	$98.17	$131.30	$240.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,734.00 / $5,786.00 / $7,714.00	Facility		$4,734.00	$5,786.00	$7,714.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.05 / $298.68 / $358.39	Professional		$201.05	$298.68	$358.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $84.99 / $100.84	Professional	26	$40.29	$84.99	$100.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $148.13 / $200.76 / $286.57	Professional	TC	$148.13	$200.76	$286.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.08 / $423.68 / $603.95	Professional		$186.08	$423.68	$603.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.51 / $111.69 / $147.44	Professional	26	$49.51	$111.69	$147.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $136.41 / $305.99 / $424.65	Professional	TC	$136.41	$305.99	$424.65
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $190.40 / $278.30 / $287.50	Professional		$190.40	$278.30	$287.50
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $55.92 / $63.95 / $63.95	Professional	26	$55.92	$63.95	$63.95
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $134.47 / $214.34 / $214.34	Professional	TC	$134.47	$214.34	$214.34
Health New England Facility/Professional Professional Modifier Low / Median / High Price $87.18 / $93.57 / $358.08	Professional		$87.18	$93.57	$358.08
United Facility/Professional Facility Modifier Low / Median / High Price $1,347.00 / $3,983.00 / $6,664.00	Facility		$1,347.00	$3,983.00	$6,664.00
United Facility/Professional Professional Modifier Low / Median / High Price $166.53 / $274.80 / $681.20	Professional		$166.53	$274.80	$681.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.95 / $68.37 / $207.77	Professional	26	$38.95	$68.37	$207.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.51 / $225.36 / $526.03	Professional	TC	$124.51	$225.36	$526.03