Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $162.18 / $190.55	Facility	26	$53.70	$162.18	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $218.78 / $645.65	Professional		$91.20	$218.78	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $87.10 / $281.84	Professional	26	$33.88	$87.10	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $77.62 / $269.15	Professional	TC	$54.95	$77.62	$269.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $213.80	Professional		$107.15	$147.91	$213.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $57.54 / $85.11	Professional	26	$38.90	$57.54	$85.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $89.13 / $128.82	Professional	TC	$67.61	$89.13	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $158.49 / $316.23	Professional		$95.50	$158.49	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $57.54 / $107.15	Professional	26	$44.67	$57.54	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $100.00 / $199.53	Professional	TC	$52.48	$100.00	$199.53
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $134.90 / $173.78	Professional		$107.15	$134.90	$173.78
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $63.10 / $95.50	Professional	26	$47.86	$63.10	$95.50
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $95.50 / $123.03	Professional	TC	$60.26	$95.50	$123.03
Health New England Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $85.11 / $234.42	Professional		$63.10	$85.11	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $218.78	Professional		$85.11	$123.03	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $45.71 / $81.28	Professional	26	$32.36	$45.71	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $79.43 / $144.54	Professional	TC	$53.70	$79.43	$144.54