Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.98 / $131.56 / $432.69	Facility		$79.98	$131.56	$432.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.10 / $36.82 / $49.11	Facility	26	$12.10	$36.82	$49.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $42.86 / $117.63 / $253.41	Facility	TC	$42.86	$117.63	$253.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.75 / $60.68 / $184.00	Professional		$24.75	$60.68	$184.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $15.54 / $57.57	Professional	26	$9.94	$15.54	$57.57
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.00 / $41.00 / $41.00	Professional	50	$41.00	$41.00	$41.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.35 / $36.44 / $125.30	Professional	TC	$24.35	$36.44	$125.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.33 / $73.61 / $124.08	Facility		$50.33	$73.61	$124.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.84 / $61.74 / $76.39	Professional		$43.84	$61.74	$76.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $15.65 / $19.41	Professional	26	$9.44	$15.65	$19.41
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $65.77 / $90.45 / $114.59	Professional	50	$65.77	$90.45	$114.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.35 / $45.80 / $59.85	Professional	TC	$34.35	$45.80	$59.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.15 / $105.39 / $219.57	Facility		$82.15	$105.39	$219.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.93 / $64.87 / $106.59	Professional		$48.93	$64.87	$106.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.27 / $15.32 / $24.85	Professional	26	$12.27	$15.32	$24.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.72 / $47.65 / $83.07	Professional	TC	$35.72	$47.65	$83.07
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $42.76 / $53.34 / $67.11	Professional		$42.76	$53.34	$67.11
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.18 / $22.26	Professional	26	$10.00	$12.18	$22.26
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $28.60 / $43.74 / $74.80	Professional	TC	$28.60	$43.74	$74.80
Health New England Facility/Professional Facility Modifier Low / Median / High Price $121.50 / $311.32 / $352.51	Facility		$121.50	$311.32	$352.51
Health New England Facility/Professional Professional Modifier Low / Median / High Price $16.77 / $31.13 / $101.37	Professional		$16.77	$31.13	$101.37
United Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $64.16 / $100.48	Professional		$39.47	$64.16	$100.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.13 / $15.94 / $24.32	Professional	26	$10.13	$15.94	$24.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.70 / $49.60 / $88.57	Professional	TC	$26.70	$49.60	$88.57