Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $162.18 / $194.98	Facility	26	$69.18	$162.18	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $275.42 / $912.01	Professional		$123.03	$275.42	$912.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $61.66 / $204.17	Professional	26	$38.02	$61.66	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $154.88 / $407.38	Professional	TC	$89.13	$154.88	$407.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $398.11 / $616.60	Professional		$141.25	$398.11	$616.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $97.72 / $138.04	Professional	26	$42.66	$97.72	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $263.03 / $478.63	Professional	TC	$100.00	$263.03	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $309.03 / $467.74	Professional		$154.88	$309.03	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $72.44 / $120.23	Professional	26	$43.65	$72.44	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $234.42 / $338.84	Professional	TC	$109.65	$234.42	$338.84
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $302.00 / $389.05	Professional		$177.83	$302.00	$389.05
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $57.54 / $83.18	Professional	26	$46.77	$57.54	$83.18
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $138.04 / $263.03	Professional	TC	$107.15	$138.04	$263.03
Health New England Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $79.43 / $338.84	Professional		$57.54	$79.43	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $208.93 / $371.54	Professional		$120.23	$208.93	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $53.70 / $104.71	Professional	26	$37.15	$53.70	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $141.25 / $257.04	Professional	TC	$85.11	$141.25	$257.04