Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.58 / $198.81 / $262.14	Facility	26	$89.58	$198.81	$262.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.64 / $342.10 / $521.41	Professional		$213.64	$342.10	$521.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $87.94 / $203.75	Professional	26	$52.78	$87.94	$203.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $142.00 / $256.04 / $440.62	Professional	TC	$142.00	$256.04	$440.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.42 / $541.38 / $755.66	Professional		$184.42	$541.38	$755.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.95 / $135.50 / $167.27	Professional	26	$58.95	$135.50	$167.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.47 / $431.35 / $602.07	Professional	TC	$125.47	$431.35	$602.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.35 / $433.87 / $668.43	Professional		$234.35	$433.87	$668.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.93 / $80.91 / $148.12	Professional	26	$65.93	$80.91	$148.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.22 / $353.89 / $491.97	Professional	TC	$167.22	$353.89	$491.97
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $201.71 / $405.92 / $495.88	Professional		$201.71	$405.92	$495.88
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $62.45 / $65.43 / $119.66	Professional	26	$62.45	$65.43	$119.66
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $131.63 / $163.85 / $287.81	Professional	TC	$131.63	$163.85	$287.81
Health New England Facility/Professional Professional Modifier Low / Median / High Price $83.76 / $110.59 / $180.93	Professional		$83.76	$110.59	$180.93
United Facility/Professional Professional Modifier Low / Median / High Price $196.90 / $319.89 / $565.08	Professional		$196.90	$319.89	$565.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.19 / $87.42 / $182.59	Professional	26	$55.19	$87.42	$182.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.13 / $231.17 / $416.02	Professional	TC	$133.13	$231.17	$416.02