Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $141.25 / $436.52	Facility		$57.54	$141.25	$436.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $32.36 / $38.02	Facility	26	$10.23	$32.36	$38.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $44.67 / $69.18 / $114.82	Facility	TC	$44.67	$69.18	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $33.11 / $125.89	Professional		$10.47	$33.11	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.59 / $42.66	Professional	26	$7.08	$12.59	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $141.25 / $281.84	Professional	50	$50.12	$141.25	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.99 / $67.61	Professional	TC	$15.85	$23.99	$67.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $58.88 / $100.00	Facility		$38.02	$58.88	$100.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $41.69 / $60.26	Professional		$25.70	$41.69	$60.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $10.96 / $16.22	Professional	26	$6.46	$10.96	$16.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $61.66 / $79.43	Professional	50	$37.15	$61.66	$79.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $41.69	Professional	TC	$19.05	$30.20	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $81.28 / $199.53	Facility		$20.89	$81.28	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $42.66 / $74.13	Professional		$28.18	$42.66	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $11.22 / $19.05	Professional	26	$7.24	$11.22	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $31.62 / $63.10	Professional	TC	$17.38	$31.62	$63.10
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $34.67 / $44.67	Professional		$27.54	$34.67	$44.67
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.47 / $12.59	Professional	26	$7.59	$10.47	$12.59
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $29.51 / $37.15	Professional	TC	$19.95	$29.51	$37.15
Health New England Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $204.17 / $223.87	Facility		$144.54	$204.17	$223.87
Health New England Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $14.45 / $56.23	Professional		$11.75	$14.45	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $35.48 / $57.54	Professional		$22.91	$35.48	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.55 / $16.22	Professional	26	$6.46	$9.55	$16.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $24.55 / $42.66	Professional	TC	$16.60	$24.55	$42.66