Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $213.80 / $257.04	Facility	26	$95.50	$213.80	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $194.98 / $645.65	Professional		$83.18	$194.98	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $85.11 / $245.47	Professional	26	$52.48	$85.11	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $213.80 / $407.38	Professional	TC	$114.82	$213.80	$407.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $457.09 / $724.44	Professional		$181.97	$457.09	$724.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $112.20 / $147.91	Professional	26	$54.95	$112.20	$147.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $316.23 / $575.44	Professional	TC	$125.89	$316.23	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $371.54 / $602.56	Professional		$229.09	$371.54	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $81.28 / $162.18	Professional	26	$54.95	$81.28	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $295.12 / $436.52	Professional	TC	$158.49	$295.12	$436.52
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $363.08 / $457.09	Professional		$239.88	$363.08	$457.09
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $72.44 / $87.10	Professional	26	$60.26	$72.44	$87.10
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $177.83 / $323.59	Professional	TC	$134.90	$177.83	$323.59
Health New England Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $95.50 / $141.25	Professional		$77.62	$95.50	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $275.42 / $501.19	Professional		$165.96	$275.42	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $66.07 / $141.25	Professional	26	$47.86	$66.07	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $199.53 / $371.54	Professional	TC	$120.23	$199.53	$371.54