Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.86 / $104.47 / $122.94	Facility	26	$29.86	$104.47	$122.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.90 / $104.65 / $460.00	Professional		$75.90	$104.65	$460.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $29.86 / $90.13	Professional	26	$22.71	$29.86	$90.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.93 / $74.78 / $205.03	Professional	TC	$54.93	$74.78	$205.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.89 / $160.19 / $205.87	Professional		$106.89	$160.19	$205.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $40.11 / $51.47	Professional	26	$25.55	$40.11	$51.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.17 / $122.77 / $154.05	Professional	TC	$81.17	$122.77	$154.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.92 / $154.94 / $264.08	Professional		$111.92	$154.94	$264.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.00 / $37.52 / $61.84	Professional	26	$30.00	$37.52	$61.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.20 / $115.51 / $202.25	Professional	TC	$80.20	$115.51	$202.25
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $97.89 / $121.04 / $153.90	Professional		$97.89	$121.04	$153.90
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $24.66 / $28.31 / $41.87	Professional	26	$24.66	$28.31	$41.87
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $63.69 / $92.43 / $115.10	Professional	TC	$63.69	$92.43	$115.10
Health New England Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $78.45 / $246.55	Professional		$37.50	$78.45	$246.55
United Facility/Professional Professional Modifier Low / Median / High Price $92.49 / $155.36 / $277.89	Professional		$92.49	$155.36	$277.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.48 / $36.77 / $64.73	Professional	26	$22.48	$36.77	$64.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.48 / $118.77 / $251.92	Professional	TC	$73.48	$118.77	$251.92