Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $154.88 / $181.97	Facility	26	$41.69	$154.88	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $323.59	Professional		$91.20	$128.82	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $58.88 / $147.91	Professional	26	$30.90	$58.88	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $85.11 / $181.97	Professional	TC	$61.66	$85.11	$181.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $169.82 / $229.09	Professional		$109.65	$169.82	$229.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $52.48 / $70.79	Professional	26	$31.62	$52.48	$70.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $117.49 / $162.18	Professional	TC	$75.86	$117.49	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $169.82 / $354.81	Professional		$100.00	$169.82	$354.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $51.29 / $85.11	Professional	26	$32.36	$51.29	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $117.49 / $245.47	Professional	TC	$66.07	$117.49	$245.47
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $131.83 / $181.97	Professional		$109.65	$131.83	$181.97
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $50.12 / $61.66	Professional	26	$31.62	$50.12	$61.66
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $114.82 / $144.54	Professional	TC	$77.62	$114.82	$144.54
Health New England Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $61.66 / $77.62	Professional		$53.70	$61.66	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $144.54 / $245.47	Professional		$93.33	$144.54	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $45.71 / $75.86	Professional	26	$30.20	$45.71	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $100.00 / $169.82	Professional	TC	$63.10	$100.00	$169.82