Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.10 / $38.75 / $49.11	Facility	26	$12.10	$38.75	$49.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.34 / $115.50 / $325.54	Facility	TC	$40.34	$115.50	$325.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.56 / $65.94 / $265.74	Professional		$24.56	$65.94	$265.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $22.79 / $74.14	Professional	26	$10.02	$22.79	$74.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $86.46 / $129.30 / $275.30	Professional	50	$86.46	$129.30	$275.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.18 / $22.06 / $48.87	Professional	52	$15.18	$22.06	$48.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $37.32 / $171.00	Professional	TC	$22.57	$37.32	$171.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.76 / $67.45 / $83.74	Professional		$42.76	$67.45	$83.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $16.84 / $20.53	Professional	26	$9.63	$16.84	$20.53
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $64.14 / $99.16 / $122.83	Professional	50	$64.14	$99.16	$122.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.13 / $51.80 / $60.88	Professional	TC	$33.13	$51.80	$60.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.97 / $64.20 / $108.30	Professional		$42.97	$64.20	$108.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.67 / $15.55 / $24.85	Professional	26	$12.67	$15.55	$24.85
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $61.21 / $61.21 / $61.21	Professional	50	$61.21	$61.21	$61.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.56 / $46.92 / $89.33	Professional	TC	$29.56	$46.92	$89.33
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $41.97 / $48.26 / $61.36	Professional		$41.97	$48.26	$61.36
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $10.99 / $12.57 / $22.92	Professional	26	$10.99	$12.57	$22.92
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $30.98 / $41.49 / $73.45	Professional	TC	$30.98	$41.49	$73.45
Health New England Facility/Professional Professional Modifier Low / Median / High Price $18.22 / $33.86 / $100.69	Professional		$18.22	$33.86	$100.69
United Facility/Professional Professional Modifier Low / Median / High Price $38.27 / $62.15 / $97.28	Professional		$38.27	$62.15	$97.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.13 / $15.83 / $24.32	Professional	26	$10.13	$15.83	$24.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.32 / $45.98 / $73.55	Professional	TC	$26.32	$45.98	$73.55