Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.68 / $101.08 / $417.89	Facility		$46.68	$101.08	$417.89
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.10 / $28.31 / $35.22	Facility	26	$9.10	$28.31	$35.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.92 / $65.48 / $100.23	Facility	TC	$21.92	$65.48	$100.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.77 / $43.80 / $146.00	Professional		$19.77	$43.80	$146.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $17.87 / $48.00	Professional	26	$7.03	$17.87	$48.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.34 / $50.34 / $189.32	Professional	50	$50.34	$50.34	$189.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.84 / $29.80 / $114.00	Professional	TC	$13.84	$29.80	$114.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.51 / $55.37 / $93.33	Facility		$31.51	$55.37	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.04 / $41.76 / $51.84	Professional		$27.04	$41.76	$51.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $11.19 / $14.38	Professional	26	$6.80	$11.19	$14.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.72 / $62.64 / $77.77	Professional	50	$39.72	$62.64	$77.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.77 / $31.18 / $37.61	Professional	TC	$19.77	$31.18	$37.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.60 / $77.79 / $235.63	Facility		$42.60	$77.79	$235.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.52 / $42.75 / $72.33	Professional		$33.52	$42.75	$72.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $10.83 / $18.69	Professional	26	$8.75	$10.83	$18.69
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.33 / $41.33 / $41.33	Professional	50	$41.33	$41.33	$41.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.30 / $31.92 / $55.08	Professional	TC	$24.30	$31.92	$55.08
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $27.60 / $33.61 / $41.38	Professional		$27.60	$33.61	$41.38
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $8.77 / $15.95	Professional	26	$7.51	$8.77	$15.95
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $20.09 / $25.64 / $43.74	Professional	TC	$20.09	$25.64	$43.74
Health New England Facility/Professional Facility Modifier Low / Median / High Price $143.65 / $181.32 / $222.04	Facility		$143.65	$181.32	$222.04
Health New England Facility/Professional Professional Modifier Low / Median / High Price $11.80 / $15.54 / $59.48	Professional		$11.80	$15.54	$59.48
United Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $40.92 / $74.39	Professional		$26.26	$40.92	$74.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $11.95 / $21.25	Professional	26	$7.38	$11.95	$21.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.61 / $28.81 / $45.69	Professional	TC	$16.61	$28.81	$45.69