Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.35 / $96.26 / $331.47	Facility		$52.35	$96.26	$331.47
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.10 / $31.04 / $36.85	Facility	26	$9.10	$31.04	$36.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.94 / $77.55 / $110.85	Facility	TC	$25.94	$77.55	$110.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.87 / $47.50 / $182.00	Professional		$22.87	$47.50	$182.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $19.17 / $56.42	Professional	26	$7.66	$19.17	$56.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.12 / $127.14 / $191.08	Professional	50	$52.12	$127.14	$191.08
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.28 / $28.49 / $121.50	Professional	52	$11.28	$28.49	$121.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.45 / $26.76 / $128.00	Professional	TC	$16.45	$26.76	$128.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.45 / $52.19 / $87.97	Facility		$36.45	$52.19	$87.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $48.47 / $60.02	Professional		$30.73	$48.47	$60.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $12.99 / $15.83	Professional	26	$7.01	$12.99	$15.83
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $46.09 / $72.68 / $90.03	Professional	50	$46.09	$72.68	$90.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $36.26 / $43.62	Professional	TC	$23.72	$36.26	$43.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.96 / $86.17 / $235.63	Facility		$45.96	$86.17	$235.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $46.91 / $83.34	Professional		$32.97	$46.91	$83.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.23 / $11.32 / $18.69	Professional	26	$9.23	$11.32	$18.69
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.09 / $47.09 / $47.09	Professional	50	$47.09	$47.09	$47.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.94 / $35.13 / $64.09	Professional	TC	$22.94	$35.13	$64.09
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $35.42 / $44.89	Professional		$30.97	$35.42	$44.89
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $8.50 / $9.16 / $16.63	Professional	26	$8.50	$9.16	$16.63
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $22.47 / $29.33 / $51.85	Professional	TC	$22.47	$29.33	$51.85
Health New England Facility/Professional Facility Modifier Low / Median / High Price $143.65 / $143.65 / $365.26	Facility		$143.65	$143.65	$365.26
Health New England Facility/Professional Professional Modifier Low / Median / High Price $11.69 / $16.50 / $53.45	Professional		$11.69	$16.50	$53.45
United Facility/Professional Professional Modifier Low / Median / High Price $28.38 / $45.77 / $72.79	Professional		$28.38	$45.77	$72.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $12.08 / $21.24	Professional	26	$6.98	$12.08	$21.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.93 / $35.74 / $54.52	Professional	TC	$20.93	$35.74	$54.52