Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.49 / $93.13 / $122.53	Facility	26	$29.49	$93.13	$122.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $111.07 / $316.47	Professional		$79.43	$111.07	$316.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.48 / $29.49 / $61.84	Professional	26	$20.48	$29.49	$61.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.95 / $81.58 / $218.51	Professional	TC	$58.95	$81.58	$218.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.03 / $200.45 / $273.30	Professional		$119.03	$200.45	$273.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.88 / $47.59 / $67.27	Professional	26	$25.88	$47.59	$67.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.54 / $152.90 / $206.02	Professional	TC	$93.54	$152.90	$206.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.21 / $186.93 / $302.16	Professional		$126.21	$186.93	$302.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.32 / $37.21 / $60.60	Professional	26	$30.32	$37.21	$60.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.56 / $141.62 / $243.35	Professional	TC	$99.56	$141.62	$243.35
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $109.32 / $135.21 / $175.49	Professional		$109.32	$135.21	$175.49
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $30.50 / $55.53	Professional	26	$25.70	$30.50	$55.53
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $81.40 / $117.13 / $207.86	Professional	TC	$81.40	$117.13	$207.86
Health New England Facility/Professional Professional Modifier Low / Median / High Price $50.79 / $54.74 / $55.86	Professional		$50.79	$54.74	$55.86
United Facility/Professional Professional Modifier Low / Median / High Price $101.51 / $168.43 / $268.51	Professional		$101.51	$168.43	$268.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.69 / $38.83 / $59.23	Professional	26	$24.69	$38.83	$59.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.61 / $136.28 / $217.30	Professional	TC	$80.61	$136.28	$217.30