Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.59 / $139.68 / $283.14	Facility		$52.59	$139.68	$283.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.73 / $27.16 / $36.85	Facility	26	$8.73	$27.16	$36.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.25 / $67.86 / $251.97	Facility	TC	$27.25	$67.86	$251.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.07 / $44.07 / $124.00	Professional		$21.07	$44.07	$124.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $12.35 / $49.25	Professional	26	$6.74	$12.35	$49.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.64 / $50.40 / $74.52	Professional	50	$48.64	$50.40	$74.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.29 / $25.97 / $113.00	Professional	TC	$15.29	$25.97	$113.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.72 / $55.37 / $93.33	Facility		$33.72	$55.37	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.04 / $42.50 / $51.84	Professional		$27.04	$42.50	$51.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.11 / $11.40 / $14.34	Professional	26	$7.11	$11.40	$14.34
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.72 / $63.91 / $77.77	Professional	50	$39.72	$63.91	$77.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.47 / $30.81 / $38.11	Professional	TC	$19.47	$30.81	$38.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.91 / $77.14 / $235.63	Facility		$42.91	$77.14	$235.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.10 / $42.75 / $70.31	Professional		$33.10	$42.75	$70.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $10.83 / $17.94	Professional	26	$8.44	$10.83	$17.94
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.76 / $39.76 / $39.76	Professional	50	$39.76	$39.76	$39.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.96 / $31.81 / $57.79	Professional	TC	$23.96	$31.81	$57.79
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $27.98 / $33.54 / $41.38	Professional		$27.98	$33.54	$41.38
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $9.16 / $16.63	Professional	26	$7.22	$9.16	$16.63
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $20.77 / $25.25 / $43.08	Professional	TC	$20.77	$25.25	$43.08
Health New England Facility/Professional Facility Modifier Low / Median / High Price $143.65 / $181.32 / $208.81	Facility		$143.65	$181.32	$208.81
Health New England Facility/Professional Professional Modifier Low / Median / High Price $12.58 / $16.64 / $43.50	Professional		$12.58	$16.64	$43.50
United Facility/Professional Professional Modifier Low / Median / High Price $24.80 / $39.83 / $59.76	Professional		$24.80	$39.83	$59.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.27 / $11.90 / $18.27	Professional	26	$7.27	$11.90	$18.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.94 / $29.43 / $44.89	Professional	TC	$17.94	$29.43	$44.89