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 $233.46 / $600.00 / $1,905.00	Professional		$233.46	$600.00	$1,905.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.81 / $145.65 / $369.72	Professional	26	$72.81	$145.65	$369.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $155.85 / $300.00 / $707.83	Professional	52	$155.85	$300.00	$707.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.39 / $433.05 / $959.18	Professional	TC	$213.39	$433.05	$959.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.81 / $730.37 / $1,060.20	Professional		$207.81	$730.37	$1,060.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.62 / $165.70 / $204.55	Professional	26	$71.62	$165.70	$204.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $136.18 / $579.34 / $872.39	Professional	TC	$136.18	$579.34	$872.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.45 / $675.06 / $960.26	Professional		$278.45	$675.06	$960.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.09 / $98.30 / $186.35	Professional	26	$80.09	$98.30	$186.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $185.04 / $515.04 / $837.85	Professional	TC	$185.04	$515.04	$837.85
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $233.33 / $611.42 / $1,050.53	Professional		$233.33	$611.42	$1,050.53
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $75.95 / $79.50 / $145.44	Professional	26	$75.95	$79.50	$145.44
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $141.90 / $176.64 / $452.29	Professional	TC	$141.90	$176.64	$452.29
Health New England Facility/Professional Professional Modifier Low / Median / High Price $109.52 / $148.00 / $572.29	Professional		$109.52	$148.00	$572.29
United Facility/Professional Professional Modifier Low / Median / High Price $217.15 / $398.11 / $752.62	Professional		$217.15	$398.11	$752.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.83 / $109.84 / $238.83	Professional	26	$66.83	$109.84	$238.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.13 / $260.14 / $502.42	Professional	TC	$140.13	$260.14	$502.42