Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.76 / $121.61 / $476.96	Facility		$61.76	$121.61	$476.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.47 / $29.46 / $38.36	Facility	26	$9.47	$29.46	$38.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.70 / $89.04 / $253.41	Facility	TC	$38.70	$89.04	$253.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.16 / $49.97 / $175.00	Professional		$15.16	$49.97	$175.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $17.25 / $51.19	Professional	26	$7.33	$17.25	$51.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $51.96 / $197.82 / $221.76	Professional	50	$51.96	$197.82	$221.76
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.04 / $17.55 / $114.54	Professional	52	$12.04	$17.55	$114.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.91 / $35.96 / $132.00	Professional	TC	$17.91	$35.96	$132.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.45 / $56.44 / $95.13	Facility		$39.45	$56.44	$95.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $52.27 / $63.40	Professional		$34.15	$52.27	$63.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $12.16 / $15.53	Professional	26	$7.37	$12.16	$15.53
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $49.71 / $77.52 / $93.77	Professional	50	$49.71	$77.52	$93.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.97 / $40.40 / $47.53	Professional	TC	$25.97	$40.40	$47.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.15 / $88.21 / $243.65	Facility		$50.15	$88.21	$243.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.83 / $49.96 / $87.04	Professional		$34.83	$49.96	$87.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $11.61 / $19.45	Professional	26	$9.52	$11.61	$19.45
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $49.18 / $49.18 / $49.18	Professional	50	$49.18	$49.18	$49.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $37.90 / $69.50	Professional	TC	$24.75	$37.90	$69.50
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $32.33 / $37.76 / $49.20	Professional		$32.33	$37.76	$49.20
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.82 / $9.53 / $17.34	Professional	26	$7.82	$9.53	$17.34
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $24.51 / $31.99 / $56.58	Professional	TC	$24.51	$31.99	$56.58
Health New England Facility/Professional Facility Modifier Low / Median / High Price $82.50 / $260.97 / $400.86	Facility		$82.50	$260.97	$400.86
Health New England Facility/Professional Professional Modifier Low / Median / High Price $13.10 / $17.67 / $72.09	Professional		$13.10	$17.67	$72.09
United Facility/Professional Professional Modifier Low / Median / High Price $30.07 / $48.89 / $77.54	Professional		$30.07	$48.89	$77.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $12.63 / $18.04	Professional	26	$7.74	$12.63	$18.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.95 / $39.49 / $59.13	Professional	TC	$22.95	$39.49	$59.13