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 $181.77 / $266.29 / $1,062.58	Professional		$181.77	$266.29	$1,062.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $93.64 / $201.54	Professional	26	$55.15	$93.64	$201.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.60 / $173.55 / $600.11	Professional	TC	$113.60	$173.55	$600.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.10 / $471.87 / $631.03	Professional		$162.10	$471.87	$631.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $142.47 / $175.87	Professional	26	$61.68	$142.47	$175.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.42 / $336.39 / $469.54	Professional	TC	$100.42	$336.39	$469.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.91 / $341.35 / $586.73	Professional		$217.91	$341.35	$586.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.97 / $84.65 / $155.81	Professional	26	$68.97	$84.65	$155.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $136.97 / $236.36 / $378.96	Professional	TC	$136.97	$236.36	$378.96
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $177.52 / $306.64 / $388.39	Professional		$177.52	$306.64	$388.39
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 $104.97 / $130.74 / $223.31	Professional	TC	$104.97	$130.74	$223.31
Health New England Facility/Professional Professional Modifier Low / Median / High Price $87.66 / $96.44 / $239.15	Professional		$87.66	$96.44	$239.15
United Facility/Professional Professional Modifier Low / Median / High Price $163.85 / $283.87 / $505.55	Professional		$163.85	$283.87	$505.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.66 / $95.58 / $192.11	Professional	26	$58.66	$95.58	$192.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.19 / $163.69 / $306.83	Professional	TC	$98.19	$163.69	$306.83