Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.57 / $98.70 / $301.62	Facility		$55.57	$98.70	$301.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.49 / $36.82 / $49.11	Facility	26	$12.49	$36.82	$49.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.31 / $92.63 / $142.33	Facility	TC	$35.31	$92.63	$142.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.06 / $62.56 / $192.00	Professional		$35.06	$62.56	$192.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.74 / $14.42 / $50.00	Professional	26	$8.74	$14.42	$50.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.60 / $31.62 / $114.72	Professional	TC	$22.60	$31.62	$114.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.59 / $69.23 / $116.69	Facility		$48.59	$69.23	$116.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.49 / $58.21 / $72.51	Professional		$38.49	$58.21	$72.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $16.14 / $19.48	Professional	26	$9.44	$16.14	$19.48
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $57.73 / $84.78 / $105.01	Professional	50	$57.73	$84.78	$105.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.03 / $41.07 / $52.00	Professional	TC	$29.03	$41.07	$52.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.30 / $130.51 / $180.90	Facility		$61.30	$130.51	$180.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.82 / $59.96 / $94.35	Professional		$46.82	$59.96	$94.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.27 / $15.70 / $25.04	Professional	26	$12.27	$15.70	$25.04
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $56.50 / $56.50 / $56.50	Professional	50	$56.50	$56.50	$56.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.17 / $43.17 / $70.40	Professional	TC	$33.17	$43.17	$70.40
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $40.89 / $50.78 / $59.89	Professional		$40.89	$50.78	$59.89
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $10.34 / $12.18 / $22.26	Professional	26	$10.34	$12.18	$22.26
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $26.55 / $36.27 / $61.97	Professional	TC	$26.55	$36.27	$61.97
Health New England Facility/Professional Professional Modifier Low / Median / High Price $15.58 / $36.00 / $82.25	Professional		$15.58	$36.00	$82.25
United Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $56.59 / $88.46	Professional		$34.79	$56.59	$88.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.82 / $15.83 / $24.32	Professional	26	$9.82	$15.83	$24.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.71 / $42.05 / $74.59	Professional	TC	$25.71	$42.05	$74.59