Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $213.80 / $251.19	Facility	26	$112.20	$213.80	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $309.03 / $794.33	Professional		$173.78	$309.03	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $83.18 / $223.87	Professional	26	$52.48	$83.18	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $218.78 / $489.78	Professional	TC	$123.03	$218.78	$489.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $512.86 / $891.25	Professional		$199.53	$512.86	$891.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $123.03 / $173.78	Professional	26	$53.70	$123.03	$173.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $363.08 / $707.95	Professional	TC	$141.25	$363.08	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $416.87 / $707.95	Professional		$251.19	$416.87	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $93.33 / $165.96	Professional	26	$60.26	$93.33	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $309.03 / $537.03	Professional	TC	$181.97	$309.03	$537.03
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $407.38 / $537.03	Professional		$257.04	$407.38	$537.03
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $72.44 / $102.33	Professional	26	$61.66	$72.44	$102.33
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $199.53 / $331.13	Professional	TC	$154.88	$199.53	$331.13
Health New England Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $85.11 / $100.00	Professional		$75.86	$85.11	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $309.03 / $562.34	Professional		$194.98	$309.03	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $69.18 / $144.54	Professional	26	$48.98	$69.18	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $229.09 / $446.68	Professional	TC	$144.54	$229.09	$446.68