Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.30 / $170.19 / $216.00	Facility	26	$78.30	$170.19	$216.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.18 / $248.29 / $1,016.92	Professional		$171.18	$248.29	$1,016.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $54.13 / $181.77	Professional	26	$44.14	$54.13	$181.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.67 / $177.61 / $707.57	Professional	TC	$97.67	$177.61	$707.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.86 / $442.66 / $617.87	Professional		$140.86	$442.66	$617.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.94 / $113.18 / $139.56	Professional	26	$47.94	$113.18	$139.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.92 / $344.76 / $483.58	Professional	TC	$92.92	$344.76	$483.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.66 / $367.97 / $527.55	Professional		$189.66	$367.97	$527.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.89 / $71.90 / $129.13	Professional	26	$54.89	$71.90	$129.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $127.05 / $280.89 / $398.42	Professional	TC	$127.05	$280.89	$398.42
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $153.99 / $329.02 / $422.13	Professional		$153.99	$329.02	$422.13
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $51.38 / $53.20 / $97.55	Professional	26	$51.38	$53.20	$97.55
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $97.37 / $121.25 / $231.95	Professional	TC	$97.37	$121.25	$231.95
Health New England Facility/Professional Professional Modifier Low / Median / High Price $73.36 / $105.68 / $147.07	Professional		$73.36	$105.68	$147.07
United Facility/Professional Professional Modifier Low / Median / High Price $150.38 / $257.06 / $469.93	Professional		$150.38	$257.06	$469.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.87 / $70.67 / $144.55	Professional	26	$45.87	$70.67	$144.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.43 / $171.20 / $312.49	Professional	TC	$103.43	$171.20	$312.49