Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.20 / $162.79 / $216.00	Facility	26	$73.20	$162.79	$216.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.29 / $232.17 / $914.17	Professional		$97.29	$232.17	$914.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $73.20 / $284.00	Professional	26	$43.82	$73.20	$284.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $112.22 / $196.90 / $300.22	Professional	50	$112.22	$196.90	$300.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.10 / $177.61 / $702.81	Professional	TC	$104.10	$177.61	$702.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.15 / $429.46 / $599.44	Professional		$140.15	$429.46	$599.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.94 / $112.27 / $138.61	Professional	26	$47.94	$112.27	$138.61
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $210.22 / $650.76 / $899.16	Professional	50	$210.22	$650.76	$899.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.21 / $338.28 / $472.17	Professional	TC	$92.21	$338.28	$472.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.16 / $318.39 / $525.00	Professional		$189.16	$318.39	$525.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.61 / $69.42 / $122.61	Professional	26	$53.61	$69.42	$122.61
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $264.70 / $264.70 / $264.70	Professional	50	$264.70	$264.70	$264.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.54 / $248.17 / $348.27	Professional	TC	$126.54	$248.17	$348.27
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $153.59 / $306.81 / $381.92	Professional		$153.59	$306.81	$381.92
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $51.38 / $53.20 / $97.55	Professional	26	$51.38	$53.20	$97.55
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $96.99 / $120.79 / $224.58	Professional	TC	$96.99	$120.79	$224.58
Health New England Facility/Professional Professional Modifier Low / Median / High Price $66.33 / $99.53 / $281.13	Professional		$66.33	$99.53	$281.13
United Facility/Professional Professional Modifier Low / Median / High Price $154.85 / $262.11 / $467.76	Professional		$154.85	$262.11	$467.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.41 / $70.67 / $146.72	Professional	26	$45.41	$70.67	$146.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.74 / $170.54 / $311.27	Professional	TC	$102.74	$170.54	$311.27