Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.95 / $246.65 / $318.94	Facility	26	$166.95	$246.65	$318.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.26 / $600.00 / $1,787.00	Professional		$313.26	$600.00	$1,787.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.43 / $166.95 / $412.16	Professional	26	$74.43	$166.95	$412.16
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $156.63 / $300.00 / $456.95	Professional	52	$156.63	$300.00	$456.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $233.00 / $433.05 / $931.29	Professional	TC	$233.00	$433.05	$931.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.09 / $732.72 / $1,074.25	Professional		$207.09	$732.72	$1,074.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.27 / $170.13 / $207.45	Professional	26	$71.27	$170.13	$207.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $135.83 / $579.34 / $872.39	Professional	TC	$135.83	$579.34	$872.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.47 / $623.79 / $887.32	Professional		$277.47	$623.79	$887.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.64 / $102.51 / $195.34	Professional	26	$82.64	$102.51	$195.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.05 / $512.05 / $755.31	Professional	TC	$184.05	$512.05	$755.31
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $234.07 / $610.34 / $1,047.78	Professional		$234.07	$610.34	$1,047.78
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $76.79 / $81.86 / $145.44	Professional	26	$76.79	$81.86	$145.44
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $141.13 / $175.70 / $445.31	Professional	TC	$141.13	$175.70	$445.31
Health New England Facility/Professional Professional Modifier Low / Median / High Price $101.30 / $159.59 / $571.34	Professional		$101.30	$159.59	$571.34
United Facility/Professional Professional Modifier Low / Median / High Price $209.57 / $396.92 / $751.37	Professional		$209.57	$396.92	$751.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.98 / $108.76 / $238.83	Professional	26	$66.98	$108.76	$238.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.78 / $258.80 / $501.17	Professional	TC	$139.78	$258.80	$501.17