Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $112.20 / $549.54	Facility		$67.61	$112.20	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $36.31 / $42.66	Facility	26	$11.48	$36.31	$42.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $54.95 / $87.10 / $251.19	Facility	TC	$54.95	$87.10	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $40.74 / $154.88	Professional		$9.55	$40.74	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.88 / $44.67	Professional	26	$7.94	$12.88	$44.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.48 / $141.25 / $281.84	Professional	50	$35.48	$141.25	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $33.88 / $87.10	Professional	TC	$19.05	$33.88	$87.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $64.57 / $109.65	Facility		$42.66	$64.57	$109.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $46.77 / $72.44	Professional		$30.20	$46.77	$72.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $13.18 / $19.05	Professional	26	$7.59	$13.18	$19.05
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $69.18 / $95.50	Professional	50	$42.66	$69.18	$95.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $32.36 / $48.98	Professional	TC	$22.39	$32.36	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $89.13 / $223.87	Facility		$25.12	$89.13	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $50.12 / $83.18	Professional		$31.62	$50.12	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.18 / $21.38	Professional	26	$8.32	$13.18	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $34.67 / $74.13	Professional	TC	$19.50	$34.67	$74.13
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.90 / $51.29	Professional		$30.90	$38.90	$51.29
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.30 / $14.79	Professional	26	$9.33	$12.30	$14.79
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $36.31 / $46.77	Professional	TC	$20.89	$36.31	$46.77
Health New England Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $245.47 / $257.04	Facility		$91.20	$245.47	$257.04
Health New England Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $16.98 / $66.07	Professional		$13.18	$16.98	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $39.81 / $67.61	Professional		$25.70	$39.81	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $10.96 / $18.20	Professional	26	$7.24	$10.96	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $28.84 / $51.29	Professional	TC	$18.62	$28.84	$51.29