Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.64 / $118.96 / $394.65	Facility		$71.64	$118.96	$394.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $34.59 / $41.48	Facility	26	$10.23	$34.59	$41.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $43.76 / $100.68 / $251.97	Facility	TC	$43.76	$100.68	$251.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.10 / $55.47 / $230.36	Professional		$19.10	$55.47	$230.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $23.26 / $55.63	Professional	26	$8.73	$23.26	$55.63
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $60.12 / $172.72 / $251.38	Professional	50	$60.12	$172.72	$251.38
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.44 / $19.93 / $129.06	Professional	52	$13.44	$19.93	$129.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.50 / $40.04 / $151.00	Professional	TC	$20.50	$40.04	$151.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.25 / $61.71 / $102.33	Facility		$43.25	$61.71	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $58.47 / $72.59	Professional		$37.07	$58.47	$72.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $13.95 / $17.01	Professional	26	$7.95	$13.95	$17.01
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $55.60 / $85.22 / $105.01	Professional	50	$55.60	$85.22	$105.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.18 / $45.26 / $53.68	Professional	TC	$29.18	$45.26	$53.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.18 / $99.60 / $243.65	Facility		$55.18	$99.60	$243.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.15 / $56.01 / $97.26	Professional		$38.15	$56.01	$97.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.37 / $12.73 / $21.02	Professional	26	$10.37	$12.73	$21.02
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $54.93 / $54.93 / $54.93	Professional	50	$54.93	$54.93	$54.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.30 / $41.76 / $77.61	Professional	TC	$27.30	$41.76	$77.61
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $36.34 / $42.50 / $53.86	Professional		$36.34	$42.50	$53.86
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $10.30 / $18.72	Professional	26	$9.44	$10.30	$18.72
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $36.17 / $64.00	Professional	TC	$26.89	$36.17	$64.00
Health New England Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $252.73 / $311.80	Facility		$90.00	$252.73	$311.80
Health New England Facility/Professional Professional Modifier Low / Median / High Price $14.21 / $28.06 / $133.55	Professional		$14.21	$28.06	$133.55
United Facility/Professional Professional Modifier Low / Median / High Price $34.11 / $55.58 / $87.10	Professional		$34.11	$55.58	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $13.47 / $20.54	Professional	26	$8.23	$13.47	$20.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $42.56 / $66.56	Professional	TC	$25.57	$42.56	$66.56