Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.56 / $106.91 / $142.38	Facility	26	$35.56	$106.91	$142.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.59 / $141.29 / $490.00	Professional		$82.59	$141.29	$490.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.64 / $55.59 / $173.00	Professional	26	$27.64	$55.59	$173.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.07 / $62.21 / $195.32	Professional	TC	$42.07	$62.21	$195.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.95 / $130.66 / $169.93	Professional		$81.95	$130.66	$169.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.17 / $46.23 / $58.63	Professional	26	$30.17	$46.23	$58.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.77 / $81.94 / $112.88	Professional	TC	$50.77	$81.94	$112.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.47 / $128.81 / $202.33	Professional		$98.47	$128.81	$202.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.36 / $43.12 / $73.28	Professional	26	$35.36	$43.12	$73.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.53 / $83.86 / $144.85	Professional	TC	$60.53	$83.86	$144.85
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $90.87 / $108.86 / $139.44	Professional		$90.87	$108.86	$139.44
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $29.07 / $39.94 / $76.06	Professional	26	$29.07	$39.94	$76.06
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $57.08 / $63.03 / $85.45	Professional	TC	$57.08	$63.03	$85.45
Health New England Facility/Professional Professional Modifier Low / Median / High Price $48.89 / $62.18 / $171.65	Professional		$48.89	$62.18	$171.65
United Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $113.80 / $203.55	Professional		$74.56	$113.80	$203.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.97 / $42.69 / $76.34	Professional	26	$27.97	$42.69	$76.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.59 / $73.26 / $158.93	Professional	TC	$46.59	$73.26	$158.93