Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $112.20 / $131.83	Facility	26	$34.67	$112.20	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $117.49 / $302.00	Professional		$81.28	$117.49	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $26.92 / $85.11	Professional	26	$21.88	$26.92	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $91.20 / $204.17	Professional	TC	$58.88	$91.20	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $186.21 / $263.03	Professional		$93.33	$186.21	$263.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $43.65 / $70.79	Professional	26	$25.70	$43.65	$70.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $141.25 / $194.98	Professional	TC	$64.57	$141.25	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $169.82 / $380.19	Professional		$104.71	$169.82	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.90 / $66.07	Professional	26	$25.12	$38.90	$66.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $125.89 / $295.12	Professional	TC	$79.43	$125.89	$295.12
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $128.82 / $190.55	Professional		$102.33	$128.82	$190.55
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $38.90 / $46.77	Professional	26	$26.30	$38.90	$46.77
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $144.54 / $181.97	Professional	TC	$72.44	$144.54	$181.97
Health New England Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $147.91 / $257.04	Professional		$95.50	$147.91	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $33.88 / $56.23	Professional	26	$22.39	$33.88	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $112.20 / $204.17	Professional	TC	$70.79	$112.20	$204.17