Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.95 / $243.15 / $314.31	Facility	26	$166.95	$243.15	$314.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $735.13 / $1,850.04	Professional		$370.50	$735.13	$1,850.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.88 / $166.95 / $365.40	Professional	26	$96.88	$166.95	$365.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $185.25 / $300.00 / $876.01	Professional	52	$185.25	$300.00	$876.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $433.05 / $931.29	Professional	TC	$259.35	$433.05	$931.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $249.65 / $757.68 / $1,057.57	Professional		$249.65	$757.68	$1,057.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.59 / $163.37 / $201.68	Professional	26	$70.59	$163.37	$201.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $179.39 / $625.01 / $872.39	Professional	TC	$179.39	$625.01	$872.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $334.23 / $617.78 / $943.73	Professional		$334.23	$617.78	$943.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.70 / $96.88 / $182.68	Professional	26	$66.70	$96.88	$182.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $242.17 / $525.86 / $748.02	Professional	TC	$242.17	$525.86	$748.02
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $298.92 / $629.69 / $1,158.32	Professional		$298.92	$629.69	$1,158.32
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $74.92 / $78.34 / $143.33	Professional	26	$74.92	$78.34	$143.33
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $185.61 / $231.14 / $507.76	Professional	TC	$185.61	$231.14	$507.76
Health New England Facility/Professional Professional Modifier Low / Median / High Price $100.32 / $132.71 / $216.73	Professional		$100.32	$132.71	$216.73
United Facility/Professional Professional Modifier Low / Median / High Price $266.72 / $486.56 / $844.09	Professional		$266.72	$486.56	$844.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.14 / $107.21 / $235.41	Professional	26	$65.14	$107.21	$235.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $184.70 / $353.35 / $677.79	Professional	TC	$184.70	$353.35	$677.79