Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.79 / $146.60 / $392.50	Facility		$75.79	$146.60	$392.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.47 / $33.54 / $39.49	Facility	26	$9.47	$33.54	$39.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.09 / $92.22 / $256.64	Facility	TC	$40.09	$92.22	$256.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.80 / $49.86 / $196.16	Professional		$23.80	$49.86	$196.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $19.55 / $59.22	Professional	26	$8.09	$19.55	$59.22
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $25.98 / $88.54 / $223.10	Professional	50	$25.98	$88.54	$223.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $40.77 / $177.89	Professional	TC	$17.32	$40.77	$177.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.18 / $56.44 / $95.13	Facility		$38.18	$56.44	$95.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.83 / $52.90 / $62.07	Professional		$33.83	$52.90	$62.07
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 $50.62 / $75.64 / $90.96	Professional	50	$50.62	$75.64	$90.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.45 / $39.54 / $47.97	Professional	TC	$26.45	$39.54	$47.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.15 / $88.21 / $235.63	Facility		$50.15	$88.21	$235.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.83 / $51.37 / $87.04	Professional		$34.83	$51.37	$87.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $11.61 / $19.45	Professional	26	$9.52	$11.61	$19.45
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $49.18 / $49.18 / $49.18	Professional	50	$49.18	$49.18	$49.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $37.90 / $66.80	Professional	TC	$24.75	$37.90	$66.80
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $31.65 / $38.82 / $67.65	Professional		$31.65	$38.82	$67.65
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.82 / $9.53 / $17.34	Professional	26	$7.82	$9.53	$17.34
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $23.83 / $33.13 / $58.61	Professional	TC	$23.83	$33.13	$58.61
Health New England Facility/Professional Facility Modifier Low / Median / High Price $143.65 / $258.42 / $676.96	Facility		$143.65	$258.42	$676.96
Health New England Facility/Professional Professional Modifier Low / Median / High Price $13.10 / $20.37 / $72.09	Professional		$13.10	$20.37	$72.09
United Facility/Professional Professional Modifier Low / Median / High Price $30.76 / $49.52 / $77.54	Professional		$30.76	$49.52	$77.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $12.38 / $19.01	Professional	26	$7.90	$12.38	$19.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.75 / $37.95 / $59.13	Professional	TC	$21.75	$37.95	$59.13