Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.43 / $270.27 / $448.63	Facility		$126.43	$270.27	$448.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.65 / $123.40 / $159.22	Facility	26	$39.65	$123.40	$159.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $100.88 / $232.08 / $358.15	Facility	TC	$100.88	$232.08	$358.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.78 / $143.07 / $647.00	Professional		$100.78	$143.07	$647.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.81 / $39.65 / $156.10	Professional	26	$27.81	$39.65	$156.10
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $44.10 / $63.22 / $108.10	Professional	52	$44.10	$63.22	$108.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.45 / $99.56 / $286.14	Professional	TC	$62.45	$99.56	$286.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $229.20 / $345.92	Facility		$150.00	$229.20	$345.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.77 / $174.61 / $241.26	Professional		$109.77	$174.61	$241.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.45 / $52.82 / $67.23	Professional	26	$34.45	$52.82	$67.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.81 / $127.02 / $175.51	Professional	TC	$73.81	$127.02	$175.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $164.76 / $295.95 / $535.27	Facility		$164.76	$295.95	$535.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.69 / $181.27 / $293.77	Professional		$124.69	$181.27	$293.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.65 / $49.83 / $82.45	Professional	26	$39.65	$49.83	$82.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.68 / $129.40 / $212.15	Professional	TC	$84.68	$129.40	$212.15
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $125.87 / $153.38 / $186.08	Professional		$125.87	$153.38	$186.08
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $34.10 / $38.22 / $54.06	Professional	26	$34.10	$38.22	$54.06
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $83.35 / $98.10 / $138.27	Professional	TC	$83.35	$98.10	$138.27
Health New England Facility/Professional Facility Modifier Low / Median / High Price $225.52 / $265.85 / $473.47	Facility		$225.52	$265.85	$473.47
Health New England Facility/Professional Professional Modifier Low / Median / High Price $56.81 / $104.60 / $229.77	Professional		$56.81	$104.60	$229.77
United Facility/Professional Professional Modifier Low / Median / High Price $99.24 / $152.12 / $274.88	Professional		$99.24	$152.12	$274.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.58 / $48.36 / $86.29	Professional	26	$30.58	$48.36	$86.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.66 / $104.14 / $188.59	Professional	TC	$68.66	$104.14	$188.59