Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.93 / $310.66 / $414.87	Facility	26	$68.93	$310.66	$414.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.71 / $243.78 / $474.42	Professional		$145.71	$243.78	$474.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $68.93 / $216.06	Professional	26	$49.69	$68.93	$216.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.22 / $138.02 / $387.01	Professional	TC	$97.22	$138.02	$387.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.91 / $429.55 / $569.49	Professional		$162.91	$429.55	$569.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.22 / $125.38 / $158.93	Professional	26	$90.22	$125.38	$158.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.69 / $293.18 / $409.77	Professional	TC	$72.69	$293.18	$409.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.16 / $433.85 / $773.63	Professional		$207.16	$433.85	$773.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.97 / $104.57 / $201.97	Professional	26	$75.97	$104.57	$201.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.12 / $281.93 / $687.50	Professional	TC	$100.12	$281.93	$687.50
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $188.77 / $386.30 / $694.95	Professional		$188.77	$386.30	$694.95
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $61.00 / $100.89 / $188.28	Professional	26	$61.00	$100.89	$188.28
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $81.45 / $101.30 / $213.87	Professional	TC	$81.45	$101.30	$213.87
Health New England Facility/Professional Professional Modifier Low / Median / High Price $142.53 / $146.15 / $237.66	Professional		$142.53	$146.15	$237.66
United Facility/Professional Professional Modifier Low / Median / High Price $154.32 / $257.39 / $564.90	Professional		$154.32	$257.39	$564.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.93 / $133.58 / $205.13	Professional	26	$71.93	$133.58	$205.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.12 / $129.57 / $256.98	Professional	TC	$76.12	$129.57	$256.98