Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.20 / $155.33 / $419.00	Facility		$66.20	$155.33	$419.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.07 / $28.22 / $37.83	Facility	26	$9.07	$28.22	$37.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $50.43 / $82.68 / $494.60	Facility	TC	$50.43	$82.68	$494.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.39 / $59.78 / $175.00	Professional		$9.39	$59.78	$175.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.28 / $12.20 / $54.66	Professional	26	$7.28	$12.20	$54.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.00 / $119.52 / $219.90	Professional	50	$52.00	$119.52	$219.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.21 / $16.14 / $107.17	Professional	52	$11.21	$16.14	$107.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.45 / $33.92 / $121.00	Professional	TC	$16.45	$33.92	$121.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.28 / $56.44 / $95.13	Facility		$36.28	$56.44	$95.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.98 / $48.92 / $60.73	Professional		$31.98	$48.92	$60.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $11.68 / $14.88	Professional	26	$7.06	$11.68	$14.88
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $46.53 / $72.66 / $89.07	Professional	50	$46.53	$72.66	$89.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.17 / $37.89 / $44.38	Professional	TC	$24.17	$37.89	$44.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.32 / $86.86 / $235.63	Facility		$49.32	$86.86	$235.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.83 / $49.55 / $81.44	Professional		$34.83	$49.55	$81.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $11.43 / $18.63	Professional	26	$9.19	$11.43	$18.63
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.03 / $46.03 / $46.03	Professional	50	$46.03	$46.03	$46.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $36.54 / $65.00	Professional	TC	$24.75	$36.54	$65.00
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $31.31 / $37.76 / $47.48	Professional		$31.31	$37.76	$47.48
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.82 / $9.14 / $16.68	Professional	26	$7.82	$9.14	$16.68
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $23.49 / $29.71 / $52.51	Professional	TC	$23.49	$29.71	$52.51
Health New England Facility/Professional Facility Modifier Low / Median / High Price $139.75 / $246.35 / $577.27	Facility		$139.75	$246.35	$577.27
Health New England Facility/Professional Professional Modifier Low / Median / High Price $12.90 / $19.62 / $67.63	Professional		$12.90	$19.62	$67.63
United Facility/Professional Professional Modifier Low / Median / High Price $28.57 / $47.36 / $72.73	Professional		$28.57	$47.36	$72.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.86 / $18.21	Professional	26	$7.59	$11.86	$18.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.36 / $34.47 / $63.41	Professional	TC	$21.36	$34.47	$63.41