Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.95 / $223.22 / $289.83	Facility	26	$166.95	$223.22	$289.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.05 / $600.00 / $2,065.67	Professional		$226.05	$600.00	$2,065.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.01 / $166.95 / $447.14	Professional	26	$89.01	$166.95	$447.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $717.68 / $717.68 / $717.68	Professional	50	$717.68	$717.68	$717.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $306.13 / $433.05 / $1,560.08	Professional	TC	$306.13	$433.05	$1,560.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $243.43 / $746.36 / $1,041.77	Professional		$243.43	$746.36	$1,041.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.73 / $149.44 / $184.48	Professional	26	$64.73	$149.44	$184.48
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $365.14 / $1,130.97 / $1,562.66	Professional	50	$365.14	$1,130.97	$1,562.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $178.70 / $625.01 / $872.39	Professional	TC	$178.70	$625.01	$872.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.62 / $609.02 / $922.04	Professional		$326.62	$609.02	$922.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.70 / $88.84 / $168.68	Professional	26	$59.70	$88.84	$168.68
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $386.61 / $386.61 / $386.61	Professional	50	$386.61	$386.61	$386.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $241.67 / $523.66 / $744.90	Professional	TC	$241.67	$523.66	$744.90
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $291.72 / $621.04 / $1,142.79	Professional		$291.72	$621.04	$1,142.79
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $69.03 / $72.23 / $132.29	Professional	26	$69.03	$72.23	$132.29
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $185.22 / $230.66 / $506.21	Professional	TC	$185.22	$230.66	$506.21
Health New England Facility/Professional Professional Modifier Low / Median / High Price $90.94 / $122.26 / $654.73	Professional		$90.94	$122.26	$654.73
United Facility/Professional Professional Modifier Low / Median / High Price $258.36 / $466.83 / $857.60	Professional		$258.36	$466.83	$857.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.76 / $98.43 / $217.22	Professional	26	$59.76	$98.43	$217.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.58 / $338.29 / $669.02	Professional	TC	$171.58	$338.29	$669.02