Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $190.55 / $223.87	Facility	26	$60.26	$190.55	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $251.19 / $602.56	Professional		$117.49	$251.19	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $91.20 / $194.98	Professional	26	$39.81	$91.20	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $100.00 / $257.04	Professional	TC	$72.44	$100.00	$257.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $288.40	Professional		$134.90	$199.53	$288.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $67.61 / $95.50	Professional	26	$45.71	$67.61	$95.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $131.83 / $190.55	Professional	TC	$89.13	$131.83	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $208.93 / $389.05	Professional		$147.91	$208.93	$389.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $66.07 / $125.89	Professional	26	$51.29	$66.07	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $128.82 / $257.04	Professional	TC	$87.10	$128.82	$257.04
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $177.83 / $218.78	Professional		$147.91	$177.83	$218.78
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $63.10 / $77.62	Professional	26	$44.67	$63.10	$77.62
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $123.03 / $154.88	Professional	TC	$102.33	$123.03	$154.88
Health New England Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $123.03 / $288.40	Professional		$93.33	$123.03	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $162.18 / $275.42	Professional		$109.65	$162.18	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $53.70 / $95.50	Professional	26	$38.02	$53.70	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $104.71 / $186.21	Professional	TC	$72.44	$104.71	$186.21