Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.54 / $164.17 / $214.75	Facility	26	$54.54	$164.17	$214.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.55 / $233.21 / $773.00	Professional		$130.55	$233.21	$773.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $59.88 / $178.04	Professional	26	$42.60	$59.88	$178.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.95 / $104.76 / $220.81	Professional	TC	$74.95	$104.76	$220.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.94 / $206.75 / $263.58	Professional		$135.94	$206.75	$263.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.81 / $71.11 / $90.50	Professional	26	$45.81	$71.11	$90.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.19 / $136.77 / $175.51	Professional	TC	$89.19	$136.77	$175.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.97 / $213.91 / $335.31	Professional		$146.97	$213.91	$335.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.33 / $66.31 / $111.89	Professional	26	$53.33	$66.31	$111.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.43 / $142.91 / $254.64	Professional	TC	$92.43	$142.91	$254.64
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $149.40 / $172.01 / $206.56	Professional		$149.40	$172.01	$206.56
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $45.04 / $51.77 / $73.14	Professional	26	$45.04	$51.77	$73.14
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $99.32 / $105.53 / $143.07	Professional	TC	$99.32	$105.53	$143.07
Health New England Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $213.27 / $314.49	Professional		$75.22	$213.27	$314.49
United Facility/Professional Professional Modifier Low / Median / High Price $116.82 / $190.01 / $339.88	Professional		$116.82	$190.01	$339.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.88 / $64.31 / $113.86	Professional	26	$42.88	$64.31	$113.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.23 / $123.12 / $222.82	Professional	TC	$73.23	$123.12	$222.82