Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.63 / $207.99 / $509.14	Facility		$85.63	$207.99	$509.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.72 / $112.54 / $158.54	Facility	26	$31.72	$112.54	$158.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $81.50 / $187.50 / $351.77	Facility	TC	$81.50	$187.50	$351.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.92 / $128.38 / $570.00	Professional		$75.92	$128.38	$570.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $35.42 / $154.33	Professional	26	$25.26	$35.42	$154.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.80 / $80.89 / $234.34	Professional	TC	$50.80	$80.89	$234.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $133.22 / $190.31 / $326.70	Facility		$133.22	$190.31	$326.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.50 / $144.97 / $200.32	Professional		$88.50	$144.97	$200.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.19 / $41.65 / $53.28	Professional	26	$27.19	$41.65	$53.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.83 / $106.42 / $148.22	Professional	TC	$59.83	$106.42	$148.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.33 / $238.00 / $535.27	Facility		$133.33	$238.00	$535.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.47 / $145.87 / $236.52	Professional		$97.47	$145.87	$236.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.91 / $39.40 / $65.98	Professional	26	$31.91	$39.40	$65.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.58 / $98.34 / $166.90	Professional	TC	$67.58	$98.34	$166.90
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $101.29 / $121.32 / $149.27	Professional		$101.29	$121.32	$149.27
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $30.51 / $43.46	Professional	26	$27.23	$30.51	$43.46
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $67.33 / $78.68 / $110.89	Professional	TC	$67.33	$78.68	$110.89
Health New England Facility/Professional Facility Modifier Low / Median / High Price $169.38 / $241.50 / $463.11	Facility		$169.38	$241.50	$463.11
Health New England Facility/Professional Professional Modifier Low / Median / High Price $37.45 / $54.07 / $176.76	Professional		$37.45	$54.07	$176.76
United Facility/Professional Professional Modifier Low / Median / High Price $78.70 / $122.31 / $221.07	Professional		$78.70	$122.31	$221.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.23 / $38.39 / $68.87	Professional	26	$25.23	$38.39	$68.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.81 / $91.47 / $152.63	Professional	TC	$55.81	$91.47	$152.63