Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.95 / $282.70 / $317.31	Facility	26	$166.95	$282.70	$317.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $600.00 / $1,272.41	Professional		$425.00	$600.00	$1,272.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.40 / $166.94 / $303.93	Professional	26	$106.40	$166.94	$303.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $433.05 / $996.85	Professional	TC	$335.00	$433.05	$996.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $360.78 / $1,148.79 / $1,603.47	Professional		$360.78	$1,148.79	$1,603.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.27 / $190.85 / $226.43	Professional	26	$71.27	$190.85	$226.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $289.52 / $986.56 / $1,377.04	Professional	TC	$289.52	$986.56	$1,377.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $487.85 / $1,145.32 / $1,629.20	Professional		$487.85	$1,145.32	$1,629.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.40 / $110.75 / $206.72	Professional	26	$86.40	$110.75	$206.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $394.92 / $1,040.83 / $1,480.56	Professional	TC	$394.92	$1,040.83	$1,480.56
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $392.58 / $1,125.06 / $1,395.18	Professional		$392.58	$1,125.06	$1,395.18
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $76.41 / $91.71 / $144.76	Professional	26	$76.41	$91.71	$144.76
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $302.80 / $376.98 / $881.32	Professional	TC	$302.80	$376.98	$881.32
Health New England Facility/Professional Professional Modifier Low / Median / High Price $101.87 / $164.66 / $179.35	Professional		$101.87	$164.66	$179.35
United Facility/Professional Professional Modifier Low / Median / High Price $361.56 / $677.34 / $1,335.84	Professional		$361.56	$677.34	$1,335.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.78 / $106.61 / $249.15	Professional	26	$69.78	$106.61	$249.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $291.77 / $545.00 / $1,113.95	Professional	TC	$291.77	$545.00	$1,113.95