Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $204.17 / $338.84	Facility		$107.15	$204.17	$338.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $128.82 / $223.87	Facility	26	$40.74	$128.82	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $97.72 / $354.81	Professional		$46.77	$97.72	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $61.66 / $138.04	Professional	26	$28.18	$61.66	$138.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $173.78 / $630.96	Professional	50	$66.07	$173.78	$630.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $58.88 / $154.88	Professional	TC	$42.66	$58.88	$154.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $154.88 / $239.88	Facility		$107.15	$154.88	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $120.23 / $177.83	Professional		$87.10	$120.23	$177.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $46.77 / $69.18	Professional	26	$32.36	$46.77	$69.18
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $128.82 / $181.97 / $263.03	Professional	50	$128.82	$181.97	$263.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $74.13 / $107.15	Professional	TC	$53.70	$74.13	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $177.83 / $309.03	Facility		$51.29	$177.83	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $229.09	Professional		$93.33	$125.89	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $46.77 / $85.11	Professional	26	$35.48	$46.77	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $79.43 / $144.54	Professional	TC	$58.88	$79.43	$144.54
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $114.82 / $144.54	Professional		$93.33	$114.82	$144.54
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $42.66 / $194.98	Professional	26	$30.90	$42.66	$194.98
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $74.13 / $194.98	Professional	TC	$52.48	$74.13	$194.98
Health New England Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $281.84 / $794.33	Facility		$169.82	$281.84	$794.33
Health New England Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $67.61 / $204.17	Professional		$46.77	$67.61	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $173.78	Professional		$69.18	$97.72	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $36.31 / $63.10	Professional	26	$25.70	$36.31	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $60.26 / $109.65	Professional	TC	$42.66	$60.26	$109.65