Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.26 / $157.74 / $332.64	Facility		$98.26	$157.74	$332.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.65 / $130.21 / $182.40	Facility	26	$36.65	$130.21	$182.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.05 / $112.35 / $485.00	Professional		$70.05	$112.35	$485.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.44 / $36.65 / $191.62	Professional	26	$30.44	$36.65	$191.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $165.80 / $637.50 / $772.00	Professional	50	$165.80	$637.50	$772.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.69 / $61.60 / $177.10	Professional	TC	$44.69	$61.60	$177.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $175.81 / $326.70	Facility		$120.00	$175.81	$326.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.10 / $129.54 / $164.87	Professional		$86.10	$129.54	$164.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.07 / $48.86 / $62.70	Professional	26	$32.07	$48.86	$62.70
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $127.78 / $194.31 / $244.78	Professional	50	$127.78	$194.31	$244.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.82 / $80.76 / $101.27	Professional	TC	$53.82	$80.76	$101.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.21 / $190.81 / $337.23	Facility		$88.21	$190.81	$337.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.22 / $125.13 / $200.34	Professional		$101.22	$125.13	$200.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.89 / $46.62 / $76.36	Professional	26	$36.89	$46.62	$76.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.56 / $77.31 / $127.97	Professional	TC	$63.56	$77.31	$127.97
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $92.34 / $101.54 / $144.65	Professional		$92.34	$101.54	$144.65
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $30.57 / $35.69 / $58.74	Professional	26	$30.57	$35.69	$58.74
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $52.45 / $59.74 / $100.93	Professional	TC	$52.45	$59.74	$100.93
Health New England Facility/Professional Facility Modifier Low / Median / High Price $158.94 / $263.25 / $441.68	Facility		$158.94	$263.25	$441.68
Health New England Facility/Professional Professional Modifier Low / Median / High Price $49.78 / $78.47 / $196.05	Professional		$49.78	$78.47	$196.05
United Facility/Professional Professional Modifier Low / Median / High Price $77.70 / $118.60 / $212.14	Professional		$77.70	$118.60	$212.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.18 / $47.42 / $79.68	Professional	26	$29.18	$47.42	$79.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.26 / $69.34 / $132.46	Professional	TC	$47.26	$69.34	$132.46