Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.95 / $198.68 / $257.48	Facility	26	$166.95	$198.68	$257.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $415.80 / $552.87 / $1,320.50	Professional		$415.80	$552.87	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.06 / $145.65 / $197.82	Professional	26	$79.06	$145.65	$197.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $433.05 / $727.72	Professional	TC	$259.35	$433.05	$727.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.87 / $912.36 / $1,273.47	Professional		$257.87	$912.36	$1,273.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.89 / $132.41 / $163.46	Professional	26	$56.89	$132.41	$163.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $198.54 / $804.85 / $1,123.40	Professional	TC	$198.54	$804.85	$1,123.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.53 / $629.03 / $936.65	Professional		$335.53	$629.03	$936.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.34 / $79.23 / $164.95	Professional	26	$64.34	$79.23	$164.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $260.42 / $551.55 / $793.90	Professional	TC	$260.42	$551.55	$793.90
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $270.62 / $622.29 / $805.34	Professional		$270.62	$622.29	$805.34
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $61.02 / $63.84 / $117.04	Professional	26	$61.02	$63.84	$117.04
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $199.73 / $248.61 / $556.64	Professional	TC	$199.73	$248.61	$556.64
Health New England Facility/Professional Professional Modifier Low / Median / High Price $79.59 / $86.73 / $146.38	Professional		$79.59	$86.73	$146.38
United Facility/Professional Professional Modifier Low / Median / High Price $254.01 / $464.96 / $877.16	Professional		$254.01	$464.96	$877.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.93 / $84.56 / $201.20	Professional	26	$53.93	$84.56	$201.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.54 / $359.89 / $735.07	Professional	TC	$192.54	$359.89	$735.07