Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $109.65 / $128.82	Facility	26	$32.36	$109.65	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $97.72 / $426.58	Professional		$51.29	$97.72	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $35.48 / $102.33	Professional	26	$20.89	$35.48	$102.33
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $35.48 / $63.10 / $147.91	Professional	52	$35.48	$63.10	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $52.48 / $123.03	Professional	TC	$25.12	$52.48	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $117.49 / $169.82	Professional		$60.26	$117.49	$169.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $38.90 / $54.95	Professional	26	$26.30	$38.90	$54.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $79.43 / $117.49	Professional	TC	$32.36	$79.43	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $112.20 / $190.55	Professional		$72.44	$112.20	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $70.79	Professional	26	$28.18	$38.02	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $67.61 / $120.23	Professional	TC	$43.65	$67.61	$120.23
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $131.83	Professional		$87.10	$104.71	$131.83
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $37.15 / $45.71	Professional	26	$25.12	$37.15	$45.71
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $57.54 / $75.86	Professional	TC	$39.81	$57.54	$75.86
Health New England Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $43.65 / $144.54	Professional		$24.55	$43.65	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $91.20 / $158.49	Professional		$61.66	$91.20	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.90 / $53.70	Professional	26	$21.88	$30.90	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $57.54 / $104.71	Professional	TC	$39.81	$57.54	$104.71