Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.94 / $284.98 / $376.72	Facility	26	$127.94	$284.98	$376.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.52 / $439.79 / $1,699.97	Professional		$231.52	$439.79	$1,699.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.20 / $99.13 / $283.67	Professional	26	$72.20	$99.13	$283.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $166.81 / $311.83 / $857.92	Professional	TC	$166.81	$311.83	$857.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.14 / $871.66 / $1,093.56	Professional		$275.14	$871.66	$1,093.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.91 / $194.35 / $239.92	Professional	26	$83.91	$194.35	$239.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $191.24 / $627.40 / $873.27	Professional	TC	$191.24	$627.40	$873.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.51 / $651.69 / $1,129.21	Professional		$380.51	$651.69	$1,129.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.83 / $115.16 / $212.32	Professional	26	$93.83	$115.16	$212.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.68 / $503.87 / $813.90	Professional	TC	$275.68	$503.87	$813.90
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $310.54 / $679.62 / $897.61	Professional		$310.54	$679.62	$897.61
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $89.88 / $93.53 / $171.25	Professional	26	$89.88	$93.53	$171.25
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $209.61 / $260.94 / $585.12	Professional	TC	$209.61	$260.94	$585.12
Health New England Facility/Professional Professional Modifier Low / Median / High Price $119.32 / $160.36 / $257.37	Professional		$119.32	$160.36	$257.37
United Facility/Professional Professional Modifier Low / Median / High Price $286.77 / $521.29 / $882.86	Professional		$286.77	$521.29	$882.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.08 / $123.35 / $252.44	Professional	26	$76.08	$123.35	$252.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $211.49 / $382.75 / $639.87	Professional	TC	$211.49	$382.75	$639.87