Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.20 / $162.79 / $216.00	Facility	26	$73.20	$162.79	$216.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.66 / $243.20 / $882.40	Professional		$134.66	$243.20	$882.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $73.20 / $242.00	Professional	26	$43.82	$73.20	$242.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $200.41 / $200.41 / $200.41	Professional	50	$200.41	$200.41	$200.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.67 / $177.61 / $600.11	Professional	TC	$97.67	$177.61	$600.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.30 / $478.92 / $598.55	Professional		$162.30	$478.92	$598.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.94 / $112.41 / $139.56	Professional	26	$47.94	$112.41	$139.56
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $243.45 / $731.91 / $897.84	Professional	50	$243.45	$731.91	$897.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.35 / $347.13 / $470.42	Professional	TC	$114.35	$347.13	$470.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $227.27 / $341.54 / $555.35	Professional		$227.27	$341.54	$555.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.61 / $69.42 / $122.61	Professional	26	$53.61	$69.42	$122.61
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $264.19 / $264.19 / $264.19	Professional	50	$264.19	$264.19	$264.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.67 / $270.10 / $432.73	Professional	TC	$164.67	$270.10	$432.73
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $182.78 / $306.81 / $381.92	Professional		$182.78	$306.81	$381.92
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $51.38 / $53.20 / $97.55	Professional	26	$51.38	$53.20	$97.55
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $125.17 / $155.79 / $266.57	Professional	TC	$125.17	$155.79	$266.57
Health New England Facility/Professional Professional Modifier Low / Median / High Price $68.18 / $99.53 / $266.50	Professional		$68.18	$99.53	$266.50
United Facility/Professional Professional Modifier Low / Median / High Price $168.37 / $272.30 / $540.91	Professional		$168.37	$272.30	$540.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.41 / $70.67 / $144.56	Professional	26	$45.41	$70.67	$144.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.15 / $219.26 / $388.37	Professional	TC	$126.15	$219.26	$388.37