Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.04 / $197.64 / $262.14	Facility	26	$89.04	$197.64	$262.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.44 / $343.45 / $877.25	Professional		$212.44	$343.45	$877.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $87.74 / $203.75	Professional	26	$52.78	$87.74	$203.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.29 / $254.42 / $440.02	Professional	TC	$140.29	$254.42	$440.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.52 / $540.13 / $753.91	Professional		$190.52	$540.13	$753.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.89 / $135.50 / $167.27	Professional	26	$57.89	$135.50	$167.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $133.19 / $430.08 / $600.30	Professional	TC	$133.19	$430.08	$600.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.10 / $433.87 / $665.29	Professional		$247.10	$433.87	$665.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.48 / $80.63 / $148.12	Professional	26	$65.48	$80.63	$148.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $170.63 / $353.89 / $476.97	Professional	TC	$170.63	$353.89	$476.97
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $200.46 / $405.03 / $494.79	Professional		$200.46	$405.03	$494.79
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $62.45 / $64.98 / $119.13	Professional	26	$62.45	$64.98	$119.13
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $130.87 / $162.90 / $287.04	Professional	TC	$130.87	$162.90	$287.04
Health New England Facility/Professional Professional Modifier Low / Median / High Price $83.28 / $111.21 / $179.97	Professional		$83.28	$111.21	$179.97
United Facility/Professional Professional Modifier Low / Median / High Price $195.82 / $337.73 / $582.77	Professional		$195.82	$337.73	$582.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.91 / $86.10 / $176.11	Professional	26	$54.91	$86.10	$176.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $136.15 / $221.43 / $412.76	Professional	TC	$136.15	$221.43	$412.76