Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $114.82 / $436.52	Facility		$77.62	$114.82	$436.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $36.31 / $42.66	Facility	26	$11.48	$36.31	$42.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $69.18 / $107.15 / $251.19	Facility	TC	$69.18	$107.15	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $46.77 / $194.98	Professional		$9.77	$46.77	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $17.78 / $54.95	Professional	26	$7.94	$17.78	$54.95
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.88 / $107.15 / $316.23	Professional	50	$33.88	$107.15	$316.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $37.15 / $87.10	Professional	TC	$22.91	$37.15	$87.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $64.57 / $109.65	Facility		$48.98	$64.57	$109.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $56.23 / $79.43	Professional		$35.48	$56.23	$79.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $13.18 / $19.05	Professional	26	$7.59	$13.18	$19.05
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $51.29 / $83.18 / $109.65	Professional	50	$51.29	$83.18	$109.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $41.69 / $60.26	Professional	TC	$28.18	$41.69	$60.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $102.33 / $223.87	Facility		$30.90	$102.33	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $56.23 / $100.00	Professional		$36.31	$56.23	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.18 / $21.38	Professional	26	$8.32	$13.18	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $42.66 / $93.33	Professional	TC	$24.55	$42.66	$93.33
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $42.66 / $61.66	Professional		$36.31	$42.66	$61.66
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.88 / $15.49	Professional	26	$9.33	$12.88	$15.49
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $45.71 / $57.54	Professional	TC	$26.92	$45.71	$57.54
Health New England Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $288.40 / $524.81	Facility		$89.13	$288.40	$524.81
Health New England Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $19.05 / $85.11	Professional		$14.13	$19.05	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $46.77 / $79.43	Professional		$30.20	$46.77	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $10.96 / $18.20	Professional	26	$7.24	$10.96	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $36.31 / $63.10	Professional	TC	$23.44	$36.31	$63.10