Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.72 / $101.64 / $310.02	Facility		$86.72	$101.64	$310.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.83 / $121.50 / $170.20	Facility	26	$56.83	$121.50	$170.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.76 / $96.21 / $303.38	Professional		$70.76	$96.21	$303.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.38 / $50.97 / $153.72	Professional	26	$39.38	$50.97	$153.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.51 / $94.51 / $652.41	Professional	50	$94.51	$94.51	$652.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.46 / $41.99 / $64.75	Professional	TC	$30.46	$41.99	$64.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $245.85 / $365.09	Facility		$120.00	$245.85	$365.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.25 / $108.10 / $159.50	Professional		$50.25	$108.10	$159.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.92 / $62.89 / $89.50	Professional	26	$30.92	$62.89	$89.50
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $75.37 / $162.15 / $238.00	Professional	50	$75.37	$162.15	$238.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $45.93 / $71.08	Professional	TC	$19.32	$45.93	$71.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.23 / $112.81 / $535.27	Facility		$60.23	$112.81	$535.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.91 / $115.94 / $182.69	Professional		$64.91	$115.94	$182.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.06 / $61.88 / $88.24	Professional	26	$38.06	$61.88	$88.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.35 / $45.23 / $95.27	Professional	TC	$23.35	$45.23	$95.27
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $63.69 / $104.48 / $175.49	Professional		$63.69	$104.48	$175.49
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $40.15 / $53.99	Professional	26	$33.11	$40.15	$53.99
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $20.20 / $25.06 / $43.26	Professional	TC	$20.20	$25.06	$43.26
Health New England Facility/Professional Professional Modifier Low / Median / High Price $46.19 / $48.36 / $91.53	Professional		$46.19	$48.36	$91.53
United Facility/Professional Professional Modifier Low / Median / High Price $46.51 / $82.57 / $161.96	Professional		$46.51	$82.57	$161.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.91 / $47.97 / $92.90	Professional	26	$28.91	$47.97	$92.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.28 / $31.54 / $68.86	Professional	TC	$19.28	$31.54	$68.86