Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $131.07 / $173.10	Facility	26	$37.43	$131.07	$173.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.51 / $125.00 / $561.00	Professional		$89.51	$125.00	$561.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $78.78 / $173.54	Professional	26	$29.91	$78.78	$173.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.61 / $87.57 / $188.49	Professional	TC	$63.61	$87.57	$188.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.83 / $179.88 / $216.13	Professional		$111.83	$179.88	$216.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.90 / $53.18 / $64.43	Professional	26	$32.90	$53.18	$64.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.84 / $127.13 / $151.69	Professional	TC	$79.84	$127.13	$151.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.38 / $165.92 / $305.74	Professional		$109.38	$165.92	$305.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.68 / $48.89 / $83.69	Professional	26	$38.68	$48.89	$83.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.09 / $116.45 / $220.92	Professional	TC	$69.09	$116.45	$220.92
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $110.19 / $129.31 / $164.27	Professional		$110.19	$129.31	$164.27
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $31.92 / $43.38 / $79.27	Professional	26	$31.92	$43.38	$79.27
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $78.34 / $94.33 / $167.33	Professional	TC	$78.34	$94.33	$167.33
Health New England Facility/Professional Professional Modifier Low / Median / High Price $55.03 / $62.67 / $118.04	Professional		$55.03	$62.67	$118.04
United Facility/Professional Professional Modifier Low / Median / High Price $104.10 / $171.28 / $266.91	Professional		$104.10	$171.28	$266.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $58.10 / $87.30	Professional	26	$34.04	$58.10	$87.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.23 / $125.25 / $179.61	Professional	TC	$75.23	$125.25	$179.61