Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $186.21 / $281.84 / $331.13	Facility	26	$186.21	$281.84	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $478.63 / $1,548.82	Professional		$213.80	$478.63	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $97.72 / $316.23	Professional	26	$66.07	$97.72	$316.23
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $107.15 / $269.15 / $588.84	Professional	52	$107.15	$269.15	$588.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $257.04 / $575.44	Professional	TC	$131.83	$257.04	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $660.69 / $1,023.29	Professional		$229.09	$660.69	$1,023.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $144.54 / $190.55	Professional	26	$74.13	$144.54	$190.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $467.74 / $851.14	Professional	TC	$147.91	$467.74	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $616.60 / $831.76	Professional		$239.88	$616.60	$831.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $104.71 / $208.93	Professional	26	$69.18	$104.71	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $446.68 / $707.95	Professional	TC	$158.49	$446.68	$707.95
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $645.65 / $1,096.48	Professional		$281.84	$645.65	$1,096.48
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $91.20 / $109.65	Professional	26	$75.86	$91.20	$109.65
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $199.53 / $602.56	Professional	TC	$154.88	$199.53	$602.56
Health New England Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $562.34	Professional		$100.00	$128.82	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $338.84 / $794.33	Professional		$194.98	$338.84	$794.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $87.10 / $208.93	Professional	26	$61.66	$87.10	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $218.78 / $524.81	Professional	TC	$128.82	$218.78	$524.81