Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $223.87 / $269.15	Facility	26	$100.00	$223.87	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $281.84 / $794.33	Professional		$169.82	$281.84	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $61.66 / $177.83	Professional	26	$51.29	$61.66	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $218.78 / $416.87	Professional	TC	$131.83	$218.78	$416.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $562.34 / $912.01	Professional		$213.80	$562.34	$912.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $114.82 / $154.88	Professional	26	$58.88	$114.82	$154.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $398.11 / $758.58	Professional	TC	$154.88	$398.11	$758.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $457.09 / $707.95	Professional		$269.15	$457.09	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $85.11 / $165.96	Professional	26	$57.54	$85.11	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $371.54 / $562.34	Professional	TC	$194.98	$371.54	$562.34
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $446.68 / $575.44	Professional		$281.84	$446.68	$575.44
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $75.86 / $91.20	Professional	26	$63.10	$75.86	$91.20
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $218.78 / $407.38	Professional	TC	$165.96	$218.78	$407.38
Health New England Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $331.13 / $602.56	Professional		$199.53	$331.13	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $69.18 / $144.54	Professional	26	$50.12	$69.18	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $251.19 / $467.74	Professional	TC	$147.91	$251.19	$467.74