Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.20 / $160.85 / $216.00	Facility	26	$73.20	$160.85	$216.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.72 / $243.20 / $1,016.92	Professional		$167.72	$243.20	$1,016.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $73.20 / $181.77	Professional	26	$44.14	$73.20	$181.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.80 / $169.99 / $306.32	Professional	TC	$104.80	$169.99	$306.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.51 / $435.74 / $608.21	Professional		$140.51	$435.74	$608.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.94 / $111.49 / $138.40	Professional	26	$47.94	$111.49	$138.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.56 / $341.06 / $481.83	Professional	TC	$92.56	$341.06	$481.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.04 / $367.97 / $527.55	Professional		$181.04	$367.97	$527.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.61 / $71.90 / $123.74	Professional	26	$53.61	$71.90	$123.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.55 / $282.73 / $398.42	Professional	TC	$126.55	$282.73	$398.42
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $153.59 / $328.56 / $422.13	Professional		$153.59	$328.56	$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 $96.99 / $120.79 / $231.17	Professional	TC	$96.99	$120.79	$231.17
Health New England Facility/Professional Professional Modifier Low / Median / High Price $68.42 / $120.68 / $147.07	Professional		$68.42	$120.68	$147.07
United Facility/Professional Professional Modifier Low / Median / High Price $155.57 / $252.91 / $462.99	Professional		$155.57	$252.91	$462.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.96 / $70.67 / $144.55	Professional	26	$46.96	$70.67	$144.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.70 / $174.14 / $312.49	Professional	TC	$103.70	$174.14	$312.49