Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.88 / $167.85 / $551.30	Facility		$73.88	$167.85	$551.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.47 / $28.78 / $38.36	Facility	26	$9.47	$28.78	$38.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $37.82 / $104.91 / $496.44	Facility	TC	$37.82	$104.91	$496.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.42 / $54.96 / $216.74	Professional		$27.42	$54.96	$216.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $19.46 / $55.78	Professional	26	$8.01	$19.46	$55.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.48 / $55.78 / $210.14	Professional	50	$19.48	$55.78	$210.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.11 / $41.59 / $171.00	Professional	TC	$21.11	$41.59	$171.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.35 / $60.73 / $95.13	Facility		$45.35	$60.73	$95.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.39 / $58.98 / $71.02	Professional		$37.39	$58.98	$71.02
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 $56.08 / $85.03 / $105.01	Professional	50	$56.08	$85.03	$105.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.09 / $47.05 / $55.35	Professional	TC	$30.09	$47.05	$55.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.70 / $99.60 / $235.63	Facility		$57.70	$99.60	$235.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.83 / $54.64 / $95.44	Professional		$34.83	$54.64	$95.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $11.78 / $19.45	Professional	26	$9.52	$11.78	$19.45
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $53.88 / $53.88 / $53.88	Professional	50	$53.88	$53.88	$53.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $42.75 / $81.22	Professional	TC	$24.75	$42.75	$81.22
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $35.59 / $41.28 / $53.65	Professional		$35.59	$41.28	$53.65
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $8.16 / $9.53 / $17.34	Professional	26	$8.16	$9.53	$17.34
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $27.91 / $37.69 / $66.70	Professional	TC	$27.91	$37.69	$66.70
Health New England Facility/Professional Facility Modifier Low / Median / High Price $82.50 / $251.78 / $291.05	Facility		$82.50	$251.78	$291.05
Health New England Facility/Professional Professional Modifier Low / Median / High Price $12.83 / $24.02 / $78.72	Professional		$12.83	$24.02	$78.72
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $54.44 / $86.34	Professional		$33.88	$54.44	$86.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $12.38 / $19.01	Professional	26	$7.37	$12.38	$19.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.30 / $43.85 / $67.38	Professional	TC	$24.30	$43.85	$67.38