Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.67 / $155.46 / $206.50	Facility	26	$71.67	$155.46	$206.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.38 / $162.11 / $750.00	Professional		$84.38	$162.11	$750.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.14 / $71.67 / $162.21	Professional	26	$42.14	$71.67	$162.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.46 / $102.81 / $220.79	Professional	TC	$63.46	$102.81	$220.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.35 / $335.83 / $398.45	Professional		$115.35	$335.83	$398.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.88 / $107.58 / $133.57	Professional	26	$45.88	$107.58	$133.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.76 / $226.81 / $275.57	Professional	TC	$70.76	$226.81	$275.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.45 / $273.47 / $438.01	Professional		$182.45	$273.47	$438.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.31 / $63.84 / $117.94	Professional	26	$51.31	$63.84	$117.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.53 / $194.23 / $320.07	Professional	TC	$124.53	$194.23	$320.07
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $228.83 / $308.83	Professional		$154.88	$228.83	$308.83
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $49.20 / $50.93 / $93.28	Professional	26	$49.20	$50.93	$93.28
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $100.41 / $125.05 / $192.39	Professional	TC	$100.41	$125.05	$192.39
Health New England Facility/Professional Professional Modifier Low / Median / High Price $69.28 / $71.04 / $100.51	Professional		$69.28	$71.04	$100.51
United Facility/Professional Professional Modifier Low / Median / High Price $139.61 / $216.02 / $429.81	Professional		$139.61	$216.02	$429.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.59 / $69.22 / $139.34	Professional	26	$43.59	$69.22	$139.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.35 / $149.83 / $294.83	Professional	TC	$94.35	$149.83	$294.83