Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.90 / $200.91 / $8,273.39	Facility		$179.90	$200.91	$8,273.39
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.70 / $278.56 / $370.05	Facility	26	$60.70	$278.56	$370.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.12 / $192.11 / $424.02	Professional		$128.12	$192.11	$424.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.60 / $68.53 / $284.72	Professional	26	$43.60	$68.53	$284.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $63.23 / $89.95 / $206.15	Professional	52	$63.23	$89.95	$206.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.52 / $126.48 / $348.12	Professional	TC	$84.52	$126.48	$348.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $271.14 / $1,188.36 / $2,243.75	Facility		$271.14	$1,188.36	$2,243.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.94 / $364.70 / $483.51	Professional		$151.94	$364.70	$483.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.09 / $110.34 / $139.36	Professional	26	$81.09	$110.34	$139.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.94 / $248.62 / $347.49	Professional	TC	$69.94	$248.62	$347.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $227.66 / $444.07 / $8,460.35	Facility		$227.66	$444.07	$8,460.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.45 / $378.20 / $763.64	Professional		$194.45	$378.20	$763.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.50 / $93.63 / $181.78	Professional	26	$66.50	$93.63	$181.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.07 / $255.47 / $687.50	Professional	TC	$94.07	$255.47	$687.50
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $172.38 / $354.06 / $685.98	Professional		$172.38	$354.06	$685.98
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $51.90 / $89.62 / $166.39	Professional	26	$51.90	$89.62	$166.39
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $76.89 / $95.61 / $185.93	Professional	TC	$76.89	$95.61	$185.93
Health New England Facility/Professional Professional Modifier Low / Median / High Price $127.33 / $213.21 / $241.89	Professional		$127.33	$213.21	$241.89
United Facility/Professional Professional Modifier Low / Median / High Price $153.43 / $243.63 / $523.50	Professional		$153.43	$243.63	$523.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.06 / $120.84 / $185.56	Professional	26	$65.06	$120.84	$185.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.42 / $120.10 / $246.04	Professional	TC	$74.42	$120.10	$246.04