Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.38 / $130.93 / $627.58	Facility		$64.38	$130.93	$627.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $33.20 / $41.48	Facility	26	$10.23	$33.20	$41.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.38 / $81.63 / $253.41	Facility	TC	$28.38	$81.63	$253.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.45 / $54.00 / $183.00	Professional		$10.45	$54.00	$183.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $13.95 / $54.17	Professional	26	$8.56	$13.95	$54.17
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $60.34 / $160.18 / $234.94	Professional	50	$60.34	$160.18	$234.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.29 / $29.71 / $160.66	Professional	TC	$15.29	$29.71	$160.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.29 / $60.71 / $102.33	Facility		$35.29	$60.71	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.92 / $49.85 / $59.72	Professional		$31.92	$49.85	$59.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $13.95 / $17.01	Professional	26	$7.95	$13.95	$17.01
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $47.40 / $72.00 / $87.20	Professional	50	$47.40	$72.00	$87.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $35.40 / $43.02	Professional	TC	$23.72	$35.40	$43.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.27 / $86.58 / $243.65	Facility		$44.27	$86.58	$243.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $50.04 / $79.15	Professional		$37.79	$50.04	$79.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.37 / $12.73 / $21.02	Professional	26	$10.37	$12.73	$21.02
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $44.46 / $44.46 / $44.46	Professional	50	$44.46	$44.46	$44.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.12 / $37.51 / $59.28	Professional	TC	$26.12	$37.51	$59.28
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $30.55 / $38.56 / $48.39	Professional		$30.55	$38.56	$48.39
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $10.30 / $18.72	Professional	26	$9.44	$10.30	$18.72
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $21.11 / $30.36 / $51.85	Professional	TC	$21.11	$30.36	$51.85
Health New England Facility/Professional Facility Modifier Low / Median / High Price $90.98 / $213.68 / $246.43	Facility		$90.98	$213.68	$246.43
Health New England Facility/Professional Professional Modifier Low / Median / High Price $14.15 / $21.88 / $71.05	Professional		$14.15	$21.88	$71.05
United Facility/Professional Professional Modifier Low / Median / High Price $28.85 / $47.84 / $73.47	Professional		$28.85	$47.84	$73.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $13.50 / $20.55	Professional	26	$8.53	$13.50	$20.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.21 / $34.50 / $52.94	Professional	TC	$21.21	$34.50	$52.94