Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $213.80 / $257.04	Facility	26	$83.18	$213.80	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $218.78 / $954.99	Professional		$114.82	$218.78	$954.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $53.70 / $173.78	Professional	26	$44.67	$53.70	$173.78
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $69.18 / $331.13 / $741.31	Professional	52	$69.18	$331.13	$741.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $125.89 / $363.08	Professional	TC	$83.18	$125.89	$363.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $416.87 / $588.84	Professional		$147.91	$416.87	$588.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $104.71 / $138.04	Professional	26	$53.70	$104.71	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $288.40 / $467.74	Professional	TC	$95.50	$288.40	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $346.74 / $512.86	Professional		$162.18	$346.74	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $75.86 / $144.54	Professional	26	$52.48	$75.86	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $263.03 / $354.81	Professional	TC	$112.20	$263.03	$354.81
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $331.13 / $426.58	Professional		$190.55	$331.13	$426.58
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $67.61 / $85.11	Professional	26	$52.48	$67.61	$85.11
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $128.82 / $269.15	Professional	TC	$100.00	$128.82	$269.15
Health New England Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $416.87	Professional		$74.13	$104.71	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $229.09 / $416.87	Professional		$138.04	$229.09	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $63.10 / $131.83	Professional	26	$47.86	$63.10	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $147.91 / $269.15	Professional	TC	$87.10	$147.91	$269.15