Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.95 / $371.53 / $485.78	Facility	26	$166.95	$371.53	$485.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $661.50 / $3,496.57	Professional		$475.00	$661.50	$3,496.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.40 / $166.95 / $389.19	Professional	26	$118.40	$166.95	$389.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $433.05 / $1,020.25	Professional	TC	$335.00	$433.05	$1,020.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $508.50 / $1,399.57 / $1,660.53	Professional		$508.50	$1,399.57	$1,660.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.80 / $250.10 / $308.74	Professional	26	$106.80	$250.10	$308.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $399.90 / $1,160.63 / $1,377.04	Professional	TC	$399.90	$1,160.63	$1,377.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $692.20 / $1,305.06 / $1,865.11	Professional		$692.20	$1,305.06	$1,865.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.25 / $149.04 / $274.61	Professional	26	$103.25	$149.04	$274.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $522.17 / $1,156.97 / $1,645.76	Professional	TC	$522.17	$1,156.97	$1,645.76
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $556.54 / $1,100.18 / $1,507.85	Professional		$556.54	$1,100.18	$1,507.85
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $115.16 / $121.86 / $222.31	Professional	26	$115.16	$121.86	$222.31
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $419.87 / $522.94 / $893.26	Professional	TC	$419.87	$522.94	$893.26
Health New England Facility/Professional Professional Modifier Low / Median / High Price $150.19 / $164.22 / $205.21	Professional		$150.19	$164.22	$205.21
United Facility/Professional Professional Modifier Low / Median / High Price $538.42 / $959.86 / $1,753.17	Professional		$538.42	$959.86	$1,753.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.55 / $160.66 / $363.94	Professional	26	$97.55	$160.66	$363.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $398.44 / $773.64 / $1,410.35	Professional	TC	$398.44	$773.64	$1,410.35