Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.64 / $209.21 / $274.45	Facility	26	$93.64	$209.21	$274.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.15 / $263.63 / $1,104.34	Professional		$145.15	$263.63	$1,104.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $93.64 / $319.97	Professional	26	$55.15	$93.64	$319.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.06 / $177.61 / $558.89	Professional	TC	$117.06	$177.61	$558.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.14 / $501.09 / $656.48	Professional		$172.14	$501.09	$656.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.03 / $142.47 / $175.87	Professional	26	$62.03	$142.47	$175.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $110.11 / $344.76 / $495.00	Professional	TC	$110.11	$344.76	$495.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.19 / $359.53 / $645.11	Professional		$231.19	$359.53	$645.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.37 / $85.14 / $155.81	Professional	26	$69.37	$85.14	$155.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $150.27 / $257.54 / $438.55	Professional	TC	$150.27	$257.54	$438.55
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $188.20 / $349.49 / $456.60	Professional		$188.20	$349.49	$456.60
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $65.59 / $68.84 / $125.95	Professional	26	$65.59	$68.84	$125.95
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $115.29 / $143.47 / $281.44	Professional	TC	$115.29	$143.47	$281.44
Health New England Facility/Professional Professional Modifier Low / Median / High Price $88.15 / $147.90 / $350.81	Professional		$88.15	$147.90	$350.81
United Facility/Professional Professional Modifier Low / Median / High Price $193.68 / $305.37 / $576.63	Professional		$193.68	$305.37	$576.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.50 / $95.03 / $175.86	Professional	26	$57.50	$95.03	$175.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.69 / $202.56 / $374.66	Professional	TC	$122.69	$202.56	$374.66