Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $93.33 / $275.42	Facility		$60.26	$93.33	$275.42
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $29.51 / $34.67	Facility	26	$9.33	$29.51	$34.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $43.65 / $70.79 / $245.47	Facility	TC	$43.65	$70.79	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $38.02 / $144.54	Professional		$16.22	$38.02	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $14.45 / $43.65	Professional	26	$6.03	$14.45	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $134.90 / $275.42	Professional	50	$45.71	$134.90	$275.42
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.23 / $38.02 / $186.21	Professional	52	$10.23	$38.02	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.39 / $63.10	Professional	TC	$15.14	$22.39	$63.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $54.95 / $93.33	Facility		$38.02	$54.95	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $38.90 / $58.88	Professional		$23.99	$38.90	$58.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.00 / $15.49	Professional	26	$6.03	$10.00	$15.49
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $58.88 / $77.62	Professional	50	$34.67	$58.88	$77.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $28.18 / $40.74	Professional	TC	$17.38	$28.18	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $77.62 / $194.98	Facility		$20.42	$77.62	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $70.79	Professional		$26.92	$41.69	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $10.47 / $17.38	Professional	26	$7.24	$10.47	$17.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $30.20 / $61.66	Professional	TC	$16.98	$30.20	$61.66
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $33.11 / $42.66	Professional		$27.54	$33.11	$42.66
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $10.47 / $12.59	Professional	26	$7.24	$10.47	$12.59
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $36.31	Professional	TC	$19.95	$28.84	$36.31
Health New England Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $199.53 / $512.86	Facility		$77.62	$199.53	$512.86
Health New England Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $13.18 / $50.12	Professional		$11.22	$13.18	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $33.88 / $56.23	Professional		$21.88	$33.88	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.91 / $14.79	Professional	26	$6.17	$8.91	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.99 / $41.69	Professional	TC	$15.85	$23.99	$41.69