Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.79 / $107.92 / $136.29	Facility	26	$33.79	$107.92	$136.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $93.80 / $146.44	Professional		$65.00	$93.80	$146.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.51 / $33.79 / $48.97	Professional	26	$23.51	$33.79	$48.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $29.67 / $46.90 / $63.22	Professional	52	$29.67	$46.90	$63.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.70 / $59.46 / $76.64	Professional	TC	$41.70	$59.46	$76.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.73 / $108.16 / $143.36	Professional		$71.73	$108.16	$143.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.61 / $44.09 / $55.50	Professional	26	$30.61	$44.09	$55.50
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $107.59 / $162.25 / $215.04	Professional	50	$107.59	$162.25	$215.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.12 / $64.33 / $89.59	Professional	TC	$41.12	$64.33	$89.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.97 / $110.31 / $174.58	Professional		$81.97	$110.31	$174.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.81 / $41.53 / $69.40	Professional	26	$32.81	$41.53	$69.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.89 / $72.06 / $106.94	Professional	TC	$46.89	$72.06	$106.94
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $76.13 / $89.87 / $119.31	Professional		$76.13	$89.87	$119.31
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $28.11 / $33.15 / $42.40	Professional	26	$28.11	$33.15	$42.40
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $43.39 / $49.64 / $88.51	Professional	TC	$43.39	$49.64	$88.51
Health New England Facility/Professional Professional Modifier Low / Median / High Price $90.59 / $93.85 / $221.57	Professional		$90.59	$93.85	$221.57
United Facility/Professional Professional Modifier Low / Median / High Price $59.09 / $94.99 / $161.31	Professional		$59.09	$94.99	$161.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $43.81 / $73.59	Professional	26	$26.96	$43.81	$73.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.13 / $51.43 / $88.66	Professional	TC	$32.13	$51.43	$88.66