Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $123.03 / $512.86	Facility		$74.13	$123.03	$512.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $33.88 / $39.81	Facility	26	$10.47	$33.88	$39.81
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $60.26 / $97.72 / $251.19	Facility	TC	$60.26	$97.72	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $40.74 / $154.88	Professional		$9.77	$40.74	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $15.85 / $48.98	Professional	26	$7.41	$15.85	$48.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $131.83 / $302.00	Professional	50	$42.66	$131.83	$302.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.89 / $125.89 / $125.89	Professional	52	$125.89	$125.89	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $38.02 / $83.18	Professional	TC	$19.95	$38.02	$83.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $58.88 / $102.33	Facility		$45.71	$58.88	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $70.79	Professional		$32.36	$50.12	$70.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $11.75 / $17.38	Professional	26	$6.92	$11.75	$17.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $74.13 / $97.72	Professional	50	$45.71	$74.13	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $37.15 / $53.70	Professional	TC	$25.12	$37.15	$53.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $93.33 / $204.17	Facility		$26.92	$93.33	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $51.29 / $91.20	Professional		$32.36	$51.29	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $19.95	Professional	26	$7.94	$12.02	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.02 / $83.18	Professional	TC	$20.89	$38.02	$83.18
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.90 / $53.70	Professional		$32.36	$38.90	$53.70
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.48 / $13.80	Professional	26	$7.76	$11.48	$13.80
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $39.81 / $50.12	Professional	TC	$24.55	$39.81	$50.12
Health New England Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $245.47 / $398.11	Facility		$83.18	$245.47	$398.11
Health New England Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $15.85 / $69.18	Professional		$12.88	$15.85	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $72.44	Professional		$26.92	$41.69	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.23 / $16.60	Professional	26	$6.76	$10.23	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $31.62 / $56.23	Professional	TC	$20.42	$31.62	$56.23