Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $145.84 / $284.52 / $422.71	Facility		$145.84	$284.52	$422.71
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.23 / $94.03 / $123.95	Facility	26	$30.23	$94.03	$123.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.48 / $130.65 / $650.00	Professional		$96.48	$130.65	$650.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $30.23 / $107.06	Professional	26	$24.07	$30.23	$107.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $45.40 / $65.30 / $118.22	Professional	52	$45.40	$65.30	$118.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.34 / $100.36 / $288.48	Professional	TC	$72.34	$100.36	$288.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.99 / $197.53 / $326.70	Facility		$134.99	$197.53	$326.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.60 / $176.99 / $231.63	Professional		$112.60	$176.99	$231.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.27 / $40.13 / $51.19	Professional	26	$26.27	$40.13	$51.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.71 / $135.81 / $180.44	Professional	TC	$84.71	$135.81	$180.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $183.34 / $312.14 / $535.27	Facility		$183.34	$312.14	$535.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.02 / $171.98 / $275.68	Professional		$106.02	$171.98	$275.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.22 / $37.52 / $62.89	Professional	26	$30.22	$37.52	$62.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.41 / $133.01 / $214.79	Professional	TC	$71.41	$133.01	$214.79
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $113.72 / $130.91 / $165.29	Professional		$113.72	$130.91	$165.29
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $25.64 / $29.42 / $40.81	Professional	26	$25.64	$29.42	$40.81
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $91.63 / $95.26 / $129.13	Professional	TC	$91.63	$95.26	$129.13
Health New England Facility/Professional Facility Modifier Low / Median / High Price $226.51 / $264.63 / $509.34	Facility		$226.51	$264.63	$509.34
Health New England Facility/Professional Professional Modifier Low / Median / High Price $38.47 / $83.25 / $271.70	Professional		$38.47	$83.25	$271.70
United Facility/Professional Professional Modifier Low / Median / High Price $100.31 / $158.27 / $302.20	Professional		$100.31	$158.27	$302.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.34 / $36.71 / $66.44	Professional	26	$24.34	$36.71	$66.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.77 / $120.73 / $216.66	Professional	TC	$75.77	$120.73	$216.66