Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.82 / $99.19 / $322.95	Facility		$46.82	$99.19	$322.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.10 / $27.65 / $36.85	Facility	26	$9.10	$27.65	$36.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.37 / $68.45 / $99.00	Facility	TC	$22.37	$68.45	$99.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $50.34 / $256.00	Professional		$20.39	$50.34	$256.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $17.28 / $55.80	Professional	26	$7.03	$17.28	$55.80
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.60 / $177.74 / $190.76	Professional	50	$48.60	$177.74	$190.76
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.19 / $14.83 / $216.00	Professional	52	$10.19	$14.83	$216.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $21.92 / $196.00	Professional	TC	$14.13	$21.92	$196.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.88 / $52.19 / $87.97	Facility		$31.88	$52.19	$87.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.60 / $44.47 / $53.73	Professional		$28.60	$44.47	$53.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $11.67 / $14.92	Professional	26	$7.01	$11.67	$14.92
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.90 / $64.06 / $78.76	Professional	50	$42.90	$64.06	$78.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.59 / $32.28 / $39.02	Professional	TC	$21.59	$32.28	$39.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.76 / $79.70 / $342.17	Facility		$41.76	$79.70	$342.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $44.98 / $74.80	Professional		$32.15	$44.98	$74.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $11.16 / $18.69	Professional	26	$9.11	$11.16	$18.69
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.89 / $42.89 / $42.89	Professional	50	$42.89	$42.89	$42.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.94 / $32.63 / $54.18	Professional	TC	$22.94	$32.63	$54.18
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $27.60 / $33.49 / $43.63	Professional		$27.60	$33.49	$43.63
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $9.16 / $16.63	Professional	26	$7.51	$9.16	$16.63
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $20.09 / $27.03 / $47.12	Professional	TC	$20.09	$27.03	$47.12
Health New England Facility/Professional Facility Modifier Low / Median / High Price $335.39 / $335.39 / $335.39	Facility		$335.39	$335.39	$335.39
Health New England Facility/Professional Professional Modifier Low / Median / High Price $12.32 / $23.13 / $62.45	Professional		$12.32	$23.13	$62.45
United Facility/Professional Professional Modifier Low / Median / High Price $26.56 / $43.73 / $67.16	Professional		$26.56	$43.73	$67.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $11.90 / $18.27	Professional	26	$7.36	$11.90	$18.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.01 / $31.83 / $48.89	Professional	TC	$19.01	$31.83	$48.89