Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.93 / $99.62 / $376.90	Facility		$64.93	$99.62	$376.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.10 / $38.75 / $49.11	Facility	26	$12.10	$38.75	$49.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.06 / $92.22 / $253.41	Facility	TC	$32.06	$92.22	$253.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.10 / $61.50 / $193.00	Professional		$35.10	$61.50	$193.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $16.52 / $37.86	Professional	26	$10.02	$16.52	$37.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $32.68 / $130.00	Professional	TC	$17.32	$32.68	$130.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.17 / $64.53 / $107.70	Facility		$45.17	$64.53	$107.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.18 / $59.35 / $70.06	Professional		$37.18	$59.35	$70.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.82 / $16.54 / $19.94	Professional	26	$9.82	$16.54	$19.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.19 / $42.01 / $51.79	Professional	TC	$27.19	$42.01	$51.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.24 / $94.57 / $243.65	Facility		$56.24	$94.57	$243.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.25 / $57.94 / $95.23	Professional		$41.25	$57.94	$95.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.27 / $15.06 / $24.85	Professional	26	$12.27	$15.06	$24.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.66 / $40.77 / $66.98	Professional	TC	$28.66	$40.77	$66.98
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $44.89 / $55.31	Professional		$37.97	$44.89	$55.31
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $10.99 / $12.18 / $22.26	Professional	26	$10.99	$12.18	$22.26
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $27.57 / $33.39 / $58.61	Professional	TC	$27.57	$33.39	$58.61
Health New England Facility/Professional Facility Modifier Low / Median / High Price $98.25 / $302.85 / $1,291.43	Facility		$98.25	$302.85	$1,291.43
Health New England Facility/Professional Professional Modifier Low / Median / High Price $15.60 / $22.62 / $81.67	Professional		$15.60	$22.62	$81.67
United Facility/Professional Professional Modifier Low / Median / High Price $33.84 / $54.07 / $84.45	Professional		$33.84	$54.07	$84.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $16.63 / $28.28	Professional	26	$10.15	$16.63	$28.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.32 / $39.15 / $60.13	Professional	TC	$24.32	$39.15	$60.13