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 $164.81 / $243.20 / $995.29	Professional		$164.81	$243.20	$995.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.97 / $73.20 / $216.00	Professional	26	$43.97	$73.20	$216.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.00 / $169.99 / $598.58	Professional	TC	$104.00	$169.99	$598.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.79 / $434.49 / $606.46	Professional		$139.79	$434.49	$606.46
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 $91.85 / $341.06 / $480.07	Professional	TC	$91.85	$341.06	$480.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.66 / $367.97 / $524.89	Professional		$188.66	$367.97	$524.89
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 $126.05 / $280.08 / $398.42	Professional	TC	$126.05	$280.08	$398.42
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $153.21 / $327.68 / $422.13	Professional		$153.21	$327.68	$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 $96.60 / $120.31 / $230.40	Professional	TC	$96.60	$120.31	$230.40
Health New England Facility/Professional Professional Modifier Low / Median / High Price $68.18 / $106.29 / $147.07	Professional		$68.18	$106.29	$147.07
United Facility/Professional Professional Modifier Low / Median / High Price $154.21 / $257.04 / $467.76	Professional		$154.21	$257.04	$467.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.95 / $81.31 / $144.56	Professional	26	$46.95	$81.31	$144.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.00 / $163.15 / $310.10	Professional	TC	$92.00	$163.15	$310.10