Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.27 / $117.61 / $298.74	Facility		$68.27	$117.61	$298.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.10 / $30.91 / $36.85	Facility	26	$9.10	$30.91	$36.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.77 / $82.68 / $251.97	Facility	TC	$31.77	$82.68	$251.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.55 / $44.96 / $172.00	Professional		$16.55	$44.96	$172.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $16.98 / $51.21	Professional	26	$7.76	$16.98	$51.21
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $51.96 / $198.02 / $385.60	Professional	50	$51.96	$198.02	$385.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.42 / $17.16 / $35.79	Professional	52	$11.42	$17.16	$35.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.72 / $30.39 / $128.00	Professional	TC	$17.72	$30.39	$128.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $35.68 / $55.37 / $93.33	Facility		$35.68	$55.37	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.71 / $48.95 / $60.22	Professional		$31.71	$48.95	$60.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.11 / $13.47 / $16.42	Professional	26	$7.11	$13.47	$16.42
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $46.54 / $72.66 / $88.13	Professional	50	$46.54	$72.66	$88.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.02 / $36.25 / $44.18	Professional	TC	$24.02	$36.25	$44.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.27 / $86.17 / $235.63	Facility		$44.27	$86.17	$235.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.75 / $49.43 / $84.28	Professional		$34.75	$49.43	$84.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $11.43 / $18.69	Professional	26	$9.78	$11.43	$18.69
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.61 / $47.61 / $47.61	Professional	50	$47.61	$47.61	$47.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.30 / $35.29 / $60.82	Professional	TC	$24.30	$35.29	$60.82
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $35.58 / $46.06	Professional		$30.24	$35.58	$46.06
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $8.81 / $9.16 / $16.63	Professional	26	$8.81	$9.16	$16.63
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $21.45 / $29.71 / $52.51	Professional	TC	$21.45	$29.71	$52.51
Health New England Facility/Professional Facility Modifier Low / Median / High Price $187.17 / $213.21 / $289.13	Facility		$187.17	$213.21	$289.13
Health New England Facility/Professional Professional Modifier Low / Median / High Price $12.90 / $23.13 / $82.61	Professional		$12.90	$23.13	$82.61
United Facility/Professional Professional Modifier Low / Median / High Price $28.76 / $47.49 / $74.38	Professional		$28.76	$47.49	$74.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $11.90 / $18.27	Professional	26	$7.36	$11.90	$18.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.70 / $36.54 / $56.11	Professional	TC	$20.70	$36.54	$56.11