Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.10 / $162.93 / $214.75	Facility	26	$54.10	$162.93	$214.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.46 / $199.86 / $654.00	Professional		$117.46	$199.86	$654.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $64.18 / $254.00	Professional	26	$42.60	$64.18	$254.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.83 / $84.76 / $317.63	Professional	TC	$59.83	$84.76	$317.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.58 / $186.51 / $240.01	Professional		$117.58	$186.51	$240.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.46 / $70.59 / $88.76	Professional	26	$45.46	$70.59	$88.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.15 / $114.80 / $151.94	Professional	TC	$71.15	$114.80	$151.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.75 / $185.37 / $291.94	Professional		$102.75	$185.37	$291.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.33 / $65.80 / $111.05	Professional	26	$53.33	$65.80	$111.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.91 / $117.02 / $203.62	Professional	TC	$50.91	$117.02	$203.62
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $130.90 / $149.75 / $200.22	Professional		$130.90	$149.75	$200.22
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $45.04 / $60.62 / $112.59	Professional	26	$45.04	$60.62	$112.59
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $79.50 / $82.42 / $116.18	Professional	TC	$79.50	$82.42	$116.18
Health New England Facility/Professional Professional Modifier Low / Median / High Price $74.68 / $97.99 / $255.45	Professional		$74.68	$97.99	$255.45
United Facility/Professional Professional Modifier Low / Median / High Price $108.43 / $165.49 / $294.24	Professional		$108.43	$165.49	$294.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.54 / $65.45 / $117.06	Professional	26	$41.54	$65.45	$117.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.55 / $99.69 / $178.96	Professional	TC	$65.55	$99.69	$178.96