Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $104.71 / $147.91	Facility	26	$33.11	$104.71	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $120.23 / $338.84	Professional		$75.86	$120.23	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $31.62 / $77.62	Professional	26	$20.89	$31.62	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $75.86 / $204.17	Professional	TC	$54.95	$75.86	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $151.36 / $223.87	Professional		$104.71	$151.36	$223.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $38.02 / $56.23	Professional	26	$25.70	$38.02	$56.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $114.82 / $158.49	Professional	TC	$79.43	$114.82	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $151.36 / $302.00	Professional		$104.71	$151.36	$302.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $67.61	Professional	26	$28.18	$38.02	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $114.82 / $229.09	Professional	TC	$75.86	$114.82	$229.09
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $123.03 / $165.96	Professional		$100.00	$123.03	$165.96
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $34.67 / $42.66	Professional	26	$24.55	$34.67	$42.66
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $100.00 / $138.04	Professional	TC	$63.10	$100.00	$138.04
Health New England Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $52.48 / $229.09	Professional		$37.15	$52.48	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $218.78	Professional		$85.11	$123.03	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $30.20 / $52.48	Professional	26	$21.38	$30.20	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $93.33 / $165.96	Professional	TC	$63.10	$93.33	$165.96