Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.95 / $246.65 / $317.31	Facility	26	$166.95	$246.65	$317.31
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $61.97 / $82.63 / $134.02	Facility	53	$61.97	$82.63	$134.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.96 / $600.00 / $2,053.00	Professional		$238.96	$600.00	$2,053.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.42 / $140.00 / $408.00	Professional	26	$68.42	$140.00	$408.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $161.57 / $300.00 / $379.19	Professional	52	$161.57	$300.00	$379.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.08 / $385.24 / $972.99	Professional	TC	$186.08	$385.24	$972.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.17 / $743.12 / $1,057.57	Professional		$213.17	$743.12	$1,057.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.27 / $163.37 / $202.78	Professional	26	$71.27	$163.37	$202.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.90 / $579.34 / $872.39	Professional	TC	$141.90	$579.34	$872.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.41 / $618.34 / $877.72	Professional		$286.41	$618.34	$877.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.69 / $97.81 / $185.30	Professional	26	$79.69	$97.81	$185.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $193.49 / $530.98 / $755.31	Professional	TC	$193.49	$530.98	$755.31
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $240.80 / $636.41 / $1,164.71	Professional		$240.80	$636.41	$1,164.71
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $75.25 / $79.09 / $144.76	Professional	26	$75.25	$79.09	$144.76
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $148.36 / $184.70 / $510.48	Professional	TC	$148.36	$184.70	$510.48
Health New England Facility/Professional Professional Modifier Low / Median / High Price $108.99 / $147.32 / $564.94	Professional		$108.99	$147.32	$564.94
United Facility/Professional Professional Modifier Low / Median / High Price $222.93 / $402.81 / $772.64	Professional		$222.93	$402.81	$772.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.78 / $108.68 / $238.83	Professional	26	$65.78	$108.68	$238.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $145.72 / $276.36 / $505.98	Professional	TC	$145.72	$276.36	$505.98