Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $104.71 / $316.23	Facility		$56.23	$104.71	$316.23
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $32.36 / $38.02	Facility	26	$10.23	$32.36	$38.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $50.12 / $75.86 / $107.15	Facility	TC	$50.12	$75.86	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $38.90 / $144.54	Professional		$12.88	$38.90	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.88 / $40.74	Professional	26	$7.08	$12.88	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $239.88 / $309.03	Professional	50	$85.11	$239.88	$309.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.96 / $28.18 / $57.54	Professional	52	$10.96	$28.18	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $66.07	Professional	TC	$16.98	$25.12	$66.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $54.95 / $93.33	Facility		$39.81	$54.95	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $42.66 / $61.66	Professional		$26.92	$42.66	$61.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $10.72 / $16.22	Professional	26	$6.31	$10.72	$16.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.81 / $64.57 / $83.18	Professional	50	$39.81	$64.57	$83.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $31.62 / $45.71	Professional	TC	$20.42	$31.62	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $87.10 / $194.98	Facility		$23.44	$87.10	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $45.71 / $81.28	Professional		$30.20	$45.71	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $11.22 / $19.05	Professional	26	$7.24	$11.22	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $33.11 / $70.79	Professional	TC	$18.62	$33.11	$70.79
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.88 / $48.98	Professional		$28.18	$33.88	$48.98
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.96 / $13.18	Professional	26	$7.59	$10.96	$13.18
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $33.11 / $42.66	Professional	TC	$20.42	$33.11	$42.66
Health New England Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $354.81	Facility		$77.62	$77.62	$354.81
Health New England Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $14.79 / $60.26	Professional		$10.96	$14.79	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $38.02 / $64.57	Professional		$24.55	$38.02	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.55 / $16.22	Professional	26	$6.46	$9.55	$16.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.18 / $48.98	Professional	TC	$18.20	$28.18	$48.98