Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $112.20 / $398.11	Facility		$66.07	$112.20	$398.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $43.65 / $60.26	Facility	26	$13.80	$43.65	$60.26
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $64.57 / $100.00 / $162.18	Facility	TC	$64.57	$100.00	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $54.95 / $173.78	Professional		$33.11	$54.95	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.79 / $41.69	Professional	26	$8.91	$14.79	$41.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $186.21 / $204.17	Professional	50	$50.12	$186.21	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $72.44 / $72.44 / $72.44	Professional	52	$72.44	$72.44	$72.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.90 / $75.86	Professional	TC	$22.39	$30.90	$75.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $74.13 / $123.03	Facility		$51.29	$74.13	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $56.23 / $74.13	Professional		$37.15	$56.23	$74.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.14 / $21.88	Professional	26	$9.33	$15.14	$21.88
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $83.18 / $107.15	Professional	50	$54.95	$83.18	$107.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $39.81 / $56.23	Professional	TC	$27.54	$39.81	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $138.04 / $194.98	Facility		$29.51	$138.04	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $60.26 / $97.72	Professional		$38.90	$60.26	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.85 / $28.18	Professional	26	$10.72	$15.85	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $43.65 / $72.44	Professional	TC	$26.92	$43.65	$72.44
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $51.29 / $64.57	Professional		$41.69	$51.29	$64.57
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.45 / $17.38	Professional	26	$10.23	$14.45	$17.38
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $42.66 / $53.70	Professional	TC	$26.30	$42.66	$53.70
Health New England Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $21.38 / $87.10	Professional		$15.14	$21.38	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $48.98 / $81.28	Professional		$33.88	$48.98	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.88 / $21.88	Professional	26	$9.12	$12.88	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $35.48 / $60.26	Professional	TC	$23.99	$35.48	$60.26