Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $27.54 / $38.02	Facility	26	$8.51	$27.54	$38.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $102.33 / $162.18	Facility	TC	$48.98	$102.33	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $42.66 / $165.96	Professional		$12.88	$42.66	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.47 / $30.90	Professional	26	$6.03	$10.47	$30.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.20 / $107.15 / $338.84	Professional	50	$18.20	$107.15	$338.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.38 / $33.88 / $117.49	Professional	52	$17.38	$33.88	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.88 / $81.28	Professional	TC	$20.89	$33.88	$81.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $48.98 / $72.44	Professional		$33.11	$48.98	$72.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $9.55 / $14.13	Professional	26	$5.62	$9.55	$14.13
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $74.13 / $95.50	Professional	50	$46.77	$74.13	$95.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $39.81 / $60.26	Professional	TC	$26.92	$39.81	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $46.77 / $91.20	Professional		$27.54	$46.77	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.55 / $15.85	Professional	26	$6.03	$9.55	$15.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $39.81 / $93.33	Professional	TC	$19.50	$39.81	$93.33
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $35.48 / $57.54	Professional		$28.18	$35.48	$57.54
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $9.12 / $10.96	Professional	26	$6.31	$9.12	$10.96
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $44.67 / $56.23	Professional	TC	$23.44	$44.67	$56.23
Health New England Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $13.49 / $72.44	Professional		$9.77	$13.49	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $41.69 / $74.13	Professional		$27.54	$41.69	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $8.13 / $13.49	Professional	26	$5.37	$8.13	$13.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $34.67 / $61.66	Professional	TC	$21.88	$34.67	$61.66