Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.79 / $90.29 / $253.41	Facility		$44.79	$90.29	$253.41
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.30 / $25.82 / $33.60	Facility	26	$8.30	$25.82	$33.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.23 / $66.81 / $245.67	Facility	TC	$23.23	$66.81	$245.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.62 / $50.38 / $184.14	Professional		$24.62	$50.38	$184.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $17.20 / $50.84	Professional	26	$6.71	$17.20	$50.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $24.30 / $50.34 / $190.76	Professional	50	$24.30	$50.34	$190.76
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.10 / $27.65 / $204.00	Professional	52	$10.10	$27.65	$204.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.42 / $21.92 / $115.00	Professional	TC	$14.42	$21.92	$115.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.82 / $52.19 / $87.97	Facility		$31.82	$52.19	$87.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.87 / $40.81 / $50.66	Professional		$25.87	$40.81	$50.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.41 / $10.65 / $13.62	Professional	26	$6.41	$10.65	$13.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.79 / $61.21 / $76.00	Professional	50	$38.79	$61.21	$76.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.47 / $30.70 / $37.51	Professional	TC	$19.47	$30.70	$37.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.93 / $76.39 / $235.63	Facility		$40.93	$76.39	$235.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $41.77 / $69.83	Professional		$32.15	$41.77	$69.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.43 / $10.49 / $17.05	Professional	26	$8.43	$10.49	$17.05
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.76 / $39.76 / $39.76	Professional	50	$39.76	$39.76	$39.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.94 / $31.43 / $55.98	Professional	TC	$22.94	$31.43	$55.98
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $27.26 / $33.01 / $39.96	Professional		$27.26	$33.01	$39.96
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.17 / $8.36 / $15.29	Professional	26	$7.17	$8.36	$15.29
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $20.09 / $24.85 / $42.39	Professional	TC	$20.09	$24.85	$42.39
Health New England Facility/Professional Facility Modifier Low / Median / High Price $77.34 / $178.16 / $305.51	Facility		$77.34	$178.16	$305.51
Health New England Facility/Professional Professional Modifier Low / Median / High Price $11.29 / $15.36 / $50.99	Professional		$11.29	$15.36	$50.99
United Facility/Professional Professional Modifier Low / Median / High Price $24.87 / $40.08 / $71.58	Professional		$24.87	$40.08	$71.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.75 / $10.84 / $16.64	Professional	26	$6.75	$10.84	$16.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.21 / $29.24 / $44.90	Professional	TC	$17.21	$29.24	$44.90