Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $42.66 / $50.12	Facility	26	$13.49	$42.66	$50.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $79.43 / $123.03 / $309.03	Facility	TC	$79.43	$123.03	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $54.95 / $229.09	Professional		$17.38	$54.95	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $20.89 / $61.66	Professional	26	$9.33	$20.89	$61.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $141.25 / $363.08	Professional	50	$45.71	$141.25	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $42.66 / $100.00	Professional	TC	$25.70	$42.66	$100.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $66.07 / $95.50	Professional		$40.74	$66.07	$95.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.85 / $22.39	Professional	26	$8.91	$15.85	$22.39
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $57.54 / $97.72 / $125.89	Professional	50	$57.54	$97.72	$125.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $47.86 / $69.18	Professional	TC	$31.62	$47.86	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $64.57 / $114.82	Professional		$40.74	$64.57	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $15.85 / $26.30	Professional	26	$9.77	$15.85	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $48.98 / $107.15	Professional	TC	$26.30	$48.98	$107.15
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $48.98 / $70.79	Professional		$41.69	$48.98	$70.79
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.14 / $18.20	Professional	26	$10.96	$15.14	$18.20
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $52.48 / $66.07	Professional	TC	$30.90	$52.48	$66.07
Health New England Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $21.38 / $89.13	Professional		$16.22	$21.38	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $53.70 / $91.20	Professional		$33.88	$53.70	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $13.18 / $21.88	Professional	26	$8.51	$13.18	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $39.81 / $70.79	Professional	TC	$25.70	$39.81	$70.79