Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $223.87 / $275.42	Facility	26	$100.00	$223.87	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $323.59 / $758.58	Professional		$213.80	$323.59	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $177.83	Professional	26	$51.29	$64.57	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $223.87 / $457.09	Professional	TC	$162.18	$223.87	$457.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $645.65 / $891.25	Professional		$245.47	$645.65	$891.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $117.49 / $154.88	Professional	26	$57.54	$117.49	$154.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $524.81 / $741.31	Professional	TC	$186.21	$524.81	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $524.81 / $831.76	Professional		$269.15	$524.81	$831.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $85.11 / $169.82	Professional	26	$57.54	$85.11	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $426.58 / $676.08	Professional	TC	$204.17	$426.58	$676.08
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $489.78 / $602.56	Professional		$338.84	$489.78	$602.56
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $75.86 / $91.20	Professional	26	$61.66	$75.86	$91.20
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $281.84 / $426.58	Professional	TC	$213.80	$281.84	$426.58
Health New England Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $89.13 / $107.15	Professional		$81.28	$89.13	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $371.54 / $660.69	Professional		$234.42	$371.54	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $69.18 / $147.91	Professional	26	$50.12	$69.18	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $295.12 / $562.34	Professional	TC	$181.97	$295.12	$562.34