Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.83 / $176.94 / $234.43	Facility	26	$79.83	$176.94	$234.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.27 / $236.72 / $895.00	Professional		$150.27	$236.72	$895.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.74 / $78.30 / $165.87	Professional	26	$46.74	$78.30	$165.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.10 / $158.41 / $547.13	Professional	TC	$95.10	$158.41	$547.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.91 / $420.65 / $587.14	Professional		$143.91	$420.65	$587.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.42 / $120.02 / $148.97	Professional	26	$52.42	$120.02	$148.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.49 / $299.57 / $451.11	Professional	TC	$91.49	$299.57	$451.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.42 / $363.17 / $520.91	Professional		$193.42	$363.17	$520.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.62 / $71.95 / $130.80	Professional	26	$58.62	$71.95	$130.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.06 / $280.08 / $398.42	Professional	TC	$125.06	$280.08	$398.42
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $157.40 / $316.43 / $409.67	Professional		$157.40	$316.43	$409.67
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $55.51 / $58.17 / $106.50	Professional	26	$55.51	$58.17	$106.50
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $95.85 / $119.36 / $217.60	Professional	TC	$95.85	$119.36	$217.60
Health New England Facility/Professional Professional Modifier Low / Median / High Price $74.51 / $99.53 / $367.06	Professional		$74.51	$99.53	$367.06
United Facility/Professional Professional Modifier Low / Median / High Price $140.02 / $250.55 / $437.53	Professional		$140.02	$250.55	$437.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.92 / $77.81 / $156.74	Professional	26	$48.92	$77.81	$156.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.11 / $166.55 / $278.44	Professional	TC	$89.11	$166.55	$278.44