Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $223.87 / $275.42	Facility	26	$100.00	$223.87	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $275.42 / $602.56	Professional		$162.18	$275.42	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $79.43 / $199.53	Professional	26	$52.48	$79.43	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $190.55 / $416.87	Professional	TC	$112.20	$190.55	$416.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $467.74 / $741.31	Professional		$194.98	$467.74	$741.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $117.49 / $154.88	Professional	26	$56.23	$117.49	$154.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $316.23 / $588.84	Professional	TC	$138.04	$316.23	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $426.58 / $616.60	Professional		$229.09	$426.58	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $85.11 / $165.96	Professional	26	$57.54	$85.11	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $338.84 / $489.78	Professional	TC	$158.49	$338.84	$489.78
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $416.87 / $489.78	Professional		$239.88	$416.87	$489.78
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $75.86 / $91.20	Professional	26	$61.66	$75.86	$91.20
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $177.83 / $338.84	Professional	TC	$134.90	$177.83	$338.84
Health New England Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $114.82	Professional		$81.28	$107.15	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $288.40 / $524.81	Professional		$169.82	$288.40	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $69.18 / $147.91	Professional	26	$50.12	$69.18	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $199.53 / $371.54	Professional	TC	$117.49	$199.53	$371.54