Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $251.19 / $309.03	Facility	26	$112.20	$251.19	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $316.23 / $933.25	Professional		$190.55	$316.23	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $77.62 / $213.80	Professional	26	$54.95	$77.62	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $218.78 / $501.19	Professional	TC	$134.90	$218.78	$501.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $562.34 / $891.25	Professional		$213.80	$562.34	$891.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $123.03 / $173.78	Professional	26	$60.26	$123.03	$173.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $389.05 / $724.44	Professional	TC	$154.88	$389.05	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $524.81 / $741.31	Professional		$239.88	$524.81	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $93.33 / $173.78	Professional	26	$63.10	$93.33	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $416.87 / $602.56	Professional	TC	$173.78	$416.87	$602.56
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $512.86 / $616.60	Professional		$281.84	$512.86	$616.60
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $102.33	Professional	26	$67.61	$79.43	$102.33
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $218.78 / $426.58	Professional	TC	$165.96	$218.78	$426.58
Health New England Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $91.20 / $316.23	Professional		$83.18	$91.20	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $338.84 / $616.60	Professional		$199.53	$338.84	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $74.13 / $162.18	Professional	26	$57.54	$74.13	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $239.88 / $436.52	Professional	TC	$141.25	$239.88	$436.52