Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $186.21 / $426.58 / $501.19	Facility	26	$186.21	$426.58	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $630.96 / $3,235.94	Professional		$398.11	$630.96	$3,235.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $165.96 / $489.78	Professional	26	$104.71	$165.96	$489.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $416.87 / $1,047.13	Professional	TC	$281.84	$416.87	$1,047.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $1,202.26 / $1,659.59	Professional		$501.19	$1,202.26	$1,659.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $218.78 / $288.40	Professional	26	$104.71	$218.78	$288.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $977.24 / $1,348.96	Professional	TC	$398.11	$977.24	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,258.93 / $1,819.70	Professional		$575.44	$1,258.93	$1,819.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $158.49 / $316.23	Professional	26	$102.33	$158.49	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $1,047.13 / $1,513.56	Professional	TC	$457.09	$1,047.13	$1,513.56
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,122.02 / $1,513.56	Professional		$660.69	$1,122.02	$1,513.56
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $141.25 / $169.82	Professional	26	$114.82	$141.25	$169.82
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $562.34 / $977.24	Professional	TC	$426.58	$562.34	$977.24
Health New England Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $169.82 / $218.78	Professional		$151.36	$169.82	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $812.83 / $1,698.24	Professional		$478.63	$812.83	$1,698.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $131.83 / $309.03	Professional	26	$93.33	$131.83	$309.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $645.65 / $1,412.54	Professional	TC	$380.19	$645.65	$1,412.54