Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.00 / $93.16 / $315.58	Facility		$37.00	$93.16	$315.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.10 / $28.31 / $36.85	Facility	26	$9.10	$28.31	$36.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.84 / $72.19 / $104.94	Facility	TC	$26.84	$72.19	$104.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.55 / $54.90 / $142.00	Professional		$25.55	$54.90	$142.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $16.39 / $49.25	Professional	26	$7.03	$16.39	$49.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.97 / $47.97 / $80.30	Professional	50	$47.97	$47.97	$80.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.63 / $18.51 / $55.80	Professional	52	$10.63	$18.51	$55.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.88 / $24.03 / $113.00	Professional	TC	$16.88	$24.03	$113.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.09 / $52.19 / $87.97	Facility		$33.09	$52.19	$87.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.21 / $46.08 / $55.18	Professional		$29.21	$46.08	$55.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $11.55 / $14.92	Professional	26	$6.71	$11.55	$14.92
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $43.81 / $66.18 / $81.59	Professional	50	$43.81	$66.18	$81.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.50 / $34.35 / $41.38	Professional	TC	$22.50	$34.35	$41.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.60 / $80.78 / $243.65	Facility		$42.60	$80.78	$243.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $45.74 / $78.40	Professional		$32.15	$45.74	$78.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $10.83 / $18.69	Professional	26	$8.83	$10.83	$18.69
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.51 / $45.51 / $45.51	Professional	50	$45.51	$45.51	$45.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.94 / $33.56 / $57.79	Professional	TC	$22.94	$33.56	$57.79
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $27.94 / $33.49 / $43.63	Professional		$27.94	$33.49	$43.63
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $8.77 / $15.95	Professional	26	$7.51	$8.77	$15.95
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $20.43 / $27.80 / $49.15	Professional	TC	$20.43	$27.80	$49.15
Health New England Facility/Professional Facility Modifier Low / Median / High Price $350.81 / $350.81 / $350.81	Facility		$350.81	$350.81	$350.81
Health New England Facility/Professional Professional Modifier Low / Median / High Price $10.90 / $15.36 / $65.44	Professional		$10.90	$15.36	$65.44
United Facility/Professional Professional Modifier Low / Median / High Price $27.12 / $43.42 / $70.37	Professional		$27.12	$43.42	$70.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $11.90 / $18.27	Professional	26	$7.36	$11.90	$18.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.80 / $32.84 / $52.10	Professional	TC	$18.80	$32.84	$52.10