Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.60 / $23.65 / $31.65	Facility	26	$7.60	$23.65	$31.65
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.00 / $95.65 / $160.65	Facility	TC	$35.00	$95.65	$160.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.31 / $46.81 / $189.00	Professional		$23.31	$46.81	$189.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.83 / $10.27 / $39.86	Professional	26	$5.83	$10.27	$39.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.64 / $52.22 / $174.34	Professional	50	$48.64	$52.22	$174.34
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.29 / $17.94 / $117.98	Professional	52	$12.29	$17.94	$117.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.37 / $27.65 / $71.11	Professional	TC	$19.37	$27.65	$71.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.95 / $53.98 / $63.00	Professional		$34.95	$53.98	$63.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.00 / $9.75 / $12.47	Professional	26	$6.00	$9.75	$12.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $52.09 / $77.19 / $92.83	Professional	50	$52.09	$77.19	$92.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.88 / $43.39 / $52.38	Professional	TC	$28.88	$43.39	$52.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.36 / $47.29 / $88.13	Professional		$28.36	$47.29	$88.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.52 / $9.32 / $15.62	Professional	26	$7.52	$9.32	$15.62
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $49.70 / $49.70 / $49.70	Professional	50	$49.70	$49.70	$49.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $38.45 / $74.91	Professional	TC	$19.30	$38.45	$74.91
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $28.95 / $34.11 / $49.83	Professional		$28.95	$34.11	$49.83
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $6.27 / $7.66 / $13.82	Professional	26	$6.27	$7.66	$13.82
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $25.19 / $36.17 / $64.00	Professional	TC	$25.19	$36.17	$64.00
Health New England Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $20.55 / $76.76	Professional		$10.72	$20.55	$76.76
United Facility/Professional Professional Modifier Low / Median / High Price $28.86 / $50.05 / $79.37	Professional		$28.86	$50.05	$79.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.28 / $9.99 / $15.23	Professional	26	$6.28	$9.99	$15.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.54 / $42.05 / $64.62	Professional	TC	$24.54	$42.05	$64.62