Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.95 / $483.08 / $670.03	Facility	26	$166.95	$483.08	$670.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $600.00 / $2,758.27	Professional		$475.00	$600.00	$2,758.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.09 / $169.86 / $621.00	Professional	26	$129.09	$169.86	$621.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $433.05 / $1,020.25	Professional	TC	$335.00	$433.05	$1,020.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $395.12 / $1,150.19 / $1,441.99	Professional		$395.12	$1,150.19	$1,441.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.78 / $289.57 / $358.45	Professional	26	$120.78	$289.57	$358.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $271.62 / $797.30 / $1,112.86	Professional	TC	$271.62	$797.30	$1,112.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $526.34 / $918.65 / $1,309.32	Professional		$526.34	$918.65	$1,309.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $137.57 / $172.46 / $311.94	Professional	26	$137.57	$172.46	$311.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $363.75 / $736.17 / $1,013.08	Professional	TC	$363.75	$736.17	$1,013.08
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $427.02 / $789.56 / $1,036.56	Professional		$427.02	$789.56	$1,036.56
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $133.66 / $138.38 / $253.40	Professional	26	$133.66	$138.38	$253.40
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $278.79 / $347.19 / $593.24	Professional	TC	$278.79	$347.19	$593.24
Health New England Facility/Professional Professional Modifier Low / Median / High Price $175.81 / $269.86 / $462.00	Professional		$175.81	$269.86	$462.00
United Facility/Professional Professional Modifier Low / Median / High Price $406.14 / $732.36 / $1,337.64	Professional		$406.14	$732.36	$1,337.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.16 / $185.84 / $412.62	Professional	26	$114.16	$185.84	$412.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $286.89 / $515.13 / $933.96	Professional	TC	$286.89	$515.13	$933.96