Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.54 / $103.93 / $307.86	Facility		$52.54	$103.93	$307.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.10 / $29.46 / $35.22	Facility	26	$9.10	$29.46	$35.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.54 / $76.34 / $247.30	Facility	TC	$26.54	$76.34	$247.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.65 / $45.55 / $156.00	Professional		$20.65	$45.55	$156.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $19.89 / $54.90	Professional	26	$7.33	$19.89	$54.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $51.96 / $112.62 / $201.58	Professional	50	$51.96	$112.62	$201.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.76 / $28.62 / $115.00	Professional	TC	$15.76	$28.62	$115.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.51 / $55.37 / $93.33	Facility		$31.51	$55.37	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.23 / $45.12 / $56.02	Professional		$29.23	$45.12	$56.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $12.03 / $14.93	Professional	26	$6.80	$12.03	$14.93
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.90 / $64.70 / $78.92	Professional	50	$42.90	$64.70	$78.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.90 / $32.13 / $40.28	Professional	TC	$21.90	$32.13	$40.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.93 / $84.47 / $235.63	Facility		$40.93	$84.47	$235.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.38 / $45.11 / $74.73	Professional		$34.38	$45.11	$74.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.99 / $11.32 / $18.07	Professional	26	$8.99	$11.32	$18.07
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.42 / $43.42 / $43.42	Professional	50	$43.42	$43.42	$43.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.00 / $34.56 / $55.43	Professional	TC	$24.00	$34.56	$55.43
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $27.48 / $35.35 / $44.70	Professional		$27.48	$35.35	$44.70
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.82 / $8.77 / $15.95	Professional	26	$7.82	$8.77	$15.95
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $19.39 / $28.39 / $48.47	Professional	TC	$19.39	$28.39	$48.47
Health New England Facility/Professional Facility Modifier Low / Median / High Price $135.85 / $209.93 / $237.71	Facility		$135.85	$209.93	$237.71
Health New England Facility/Professional Professional Modifier Low / Median / High Price $11.80 / $15.97 / $58.61	Professional		$11.80	$15.97	$58.61
United Facility/Professional Professional Modifier Low / Median / High Price $26.66 / $43.46 / $67.98	Professional		$26.66	$43.46	$67.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.28 / $11.38 / $17.47	Professional	26	$7.28	$11.38	$17.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.39 / $31.85 / $50.51	Professional	TC	$19.39	$31.85	$50.51