Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.95 / $295.73 / $384.47	Facility	26	$166.95	$295.73	$384.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $600.00 / $1,976.42	Professional		$425.00	$600.00	$1,976.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $166.95 / $389.19	Professional	26	$111.15	$166.95	$389.19
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $185.25 / $300.00 / $523.50	Professional	52	$185.25	$300.00	$523.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $267.81 / $385.24 / $757.53	Professional	TC	$267.81	$385.24	$757.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $294.37 / $966.44 / $1,348.96	Professional		$294.37	$966.44	$1,348.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.63 / $198.23 / $244.71	Professional	26	$85.63	$198.23	$244.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $208.74 / $746.61 / $1,124.27	Professional	TC	$208.74	$746.61	$1,124.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $396.50 / $782.83 / $1,112.94	Professional		$396.50	$782.83	$1,112.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.76 / $117.69 / $223.12	Professional	26	$95.76	$117.69	$223.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $284.27 / $636.97 / $906.08	Professional	TC	$284.27	$636.97	$906.08
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $321.10 / $748.24 / $900.61	Professional		$321.10	$748.24	$900.61
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $91.24 / $95.44 / $174.72	Professional	26	$91.24	$95.44	$174.72
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $217.97 / $271.36 / $561.67	Professional	TC	$217.97	$271.36	$561.67
Health New England Facility/Professional Professional Modifier Low / Median / High Price $122.34 / $163.02 / $172.33	Professional		$122.34	$163.02	$172.33
United Facility/Professional Professional Modifier Low / Median / High Price $306.45 / $554.35 / $995.44	Professional		$306.45	$554.35	$995.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.06 / $132.87 / $287.77	Professional	26	$79.06	$132.87	$287.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $221.86 / $402.35 / $707.67	Professional	TC	$221.86	$402.35	$707.67