Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.06 / $109.72 / $129.12	Facility	26	$29.06	$109.72	$129.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.50 / $98.65 / $427.00	Professional		$68.50	$98.65	$427.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $29.06 / $109.95	Professional	26	$23.46	$29.06	$109.95
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $34.25 / $49.33 / $151.61	Professional	52	$34.25	$49.33	$151.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.12 / $63.59 / $116.01	Professional	TC	$48.12	$63.59	$116.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.03 / $118.24 / $168.27	Professional		$58.03	$118.24	$168.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.47 / $40.64 / $49.90	Professional	26	$26.47	$40.64	$49.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.52 / $77.09 / $118.37	Professional	TC	$31.52	$77.09	$118.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.13 / $116.64 / $191.02	Professional		$76.13	$116.64	$191.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $37.14 / $60.52	Professional	26	$29.75	$37.14	$60.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.60 / $67.75 / $121.93	Professional	TC	$43.60	$67.75	$121.93
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $74.52 / $101.54 / $122.12	Professional		$74.52	$101.54	$122.12
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $25.00 / $29.74 / $40.28	Professional	26	$25.00	$29.74	$40.28
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $35.40 / $44.01 / $72.08	Professional	TC	$35.40	$44.01	$72.08
Health New England Facility/Professional Professional Modifier Low / Median / High Price $38.96 / $48.37 / $228.75	Professional		$38.96	$48.37	$228.75
United Facility/Professional Professional Modifier Low / Median / High Price $66.28 / $95.44 / $191.67	Professional		$66.28	$95.44	$191.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.75 / $38.10 / $67.98	Professional	26	$24.75	$38.10	$67.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.71 / $58.49 / $114.36	Professional	TC	$39.71	$58.49	$114.36