Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.95 / $224.45 / $292.83	Facility	26	$166.95	$224.45	$292.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.88 / $494.18 / $2,064.73	Professional		$144.88	$494.18	$2,064.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.62 / $166.95 / $459.10	Professional	26	$69.62	$166.95	$459.10
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $262.06 / $262.06 / $262.06	Professional	50	$262.06	$262.06	$262.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $165.89 / $300.00 / $444.61	Professional	52	$165.89	$300.00	$444.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $241.98 / $433.05 / $1,009.00	Professional	TC	$241.98	$433.05	$1,009.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $220.57 / $747.57 / $1,045.29	Professional		$220.57	$747.57	$1,045.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.45 / $152.54 / $188.30	Professional	26	$65.45	$152.54	$188.30
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $330.85 / $1,123.32 / $1,567.93	Professional	50	$330.85	$1,123.32	$1,567.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $155.12 / $579.34 / $872.39	Professional	TC	$155.12	$579.34	$872.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.68 / $605.22 / $854.92	Professional		$297.68	$605.22	$854.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.13 / $88.10 / $170.53	Professional	26	$61.13	$88.10	$170.53
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $343.71 / $343.71 / $343.71	Professional	50	$343.71	$343.71	$343.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.98 / $523.66 / $744.90	Professional	TC	$201.98	$523.66	$744.90
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $247.64 / $621.04 / $1,119.04	Professional		$247.64	$621.04	$1,119.04
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $70.12 / $72.63 / $132.97	Professional	26	$70.12	$72.63	$132.97
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $162.86 / $202.65 / $493.80	Professional	TC	$162.86	$202.65	$493.80
Health New England Facility/Professional Professional Modifier Low / Median / High Price $98.53 / $143.88 / $603.72	Professional		$98.53	$143.88	$603.72
United Facility/Professional Professional Modifier Low / Median / High Price $232.04 / $432.41 / $1,069.74	Professional		$232.04	$432.41	$1,069.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.96 / $100.84 / $218.41	Professional	26	$60.96	$100.84	$218.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.79 / $295.87 / $566.27	Professional	TC	$162.79	$295.87	$566.27