Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.44 / $96.75 / $308.95	Facility		$56.44	$96.75	$308.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.47 / $29.46 / $38.36	Facility	26	$9.47	$29.46	$38.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.17 / $77.40 / $251.97	Facility	TC	$28.17	$77.40	$251.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.10 / $45.55 / $172.00	Professional		$12.10	$45.55	$172.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $17.98 / $53.84	Professional	26	$7.33	$17.98	$53.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $51.96 / $55.78 / $240.62	Professional	50	$51.96	$55.78	$240.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.91 / $29.64 / $128.00	Professional	TC	$17.91	$29.64	$128.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.45 / $60.71 / $102.33	Facility		$39.45	$60.71	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.11 / $49.60 / $59.83	Professional		$30.11	$49.60	$59.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $12.16 / $15.53	Professional	26	$7.37	$12.16	$15.53
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $44.70 / $74.83 / $87.53	Professional	50	$44.70	$74.83	$87.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.50 / $37.45 / $45.16	Professional	TC	$22.50	$37.45	$45.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.51 / $86.58 / $235.63	Facility		$47.51	$86.58	$235.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.38 / $48.11 / $77.70	Professional		$37.38	$48.11	$77.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $11.61 / $19.45	Professional	26	$9.52	$11.61	$19.45
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.94 / $43.94 / $43.94	Professional	50	$43.94	$43.94	$43.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.11 / $36.36 / $69.50	Professional	TC	$27.11	$36.36	$69.50
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $35.03 / $39.64 / $46.07	Professional		$35.03	$39.64	$46.07
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.82 / $9.53 / $17.34	Professional	26	$7.82	$9.53	$17.34
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $25.87 / $28.79 / $49.15	Professional	TC	$25.87	$28.79	$49.15
Health New England Facility/Professional Facility Modifier Low / Median / High Price $88.50 / $143.65 / $230.75	Facility		$88.50	$143.65	$230.75
Health New England Facility/Professional Professional Modifier Low / Median / High Price $11.85 / $25.22 / $85.27	Professional		$11.85	$25.22	$85.27
United Facility/Professional Professional Modifier Low / Median / High Price $26.69 / $45.05 / $68.70	Professional		$26.69	$45.05	$68.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $12.46 / $19.01	Professional	26	$7.90	$12.46	$19.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.44 / $33.10 / $50.18	Professional	TC	$20.44	$33.10	$50.18