Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.82 / $142.01 / $185.53	Facility	26	$47.82	$142.01	$185.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.43 / $197.08 / $648.00	Professional		$93.43	$197.08	$648.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $73.59 / $287.56	Professional	26	$36.61	$73.59	$287.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.82 / $81.98 / $356.00	Professional	TC	$56.82	$81.98	$356.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.91 / $161.52 / $209.88	Professional		$109.91	$161.52	$209.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.54 / $59.93 / $79.03	Professional	26	$39.54	$59.93	$79.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.81 / $98.31 / $125.65	Professional	TC	$68.81	$98.31	$125.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.12 / $169.97 / $269.16	Professional		$96.12	$169.97	$269.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.07 / $57.35 / $96.63	Professional	26	$46.07	$57.35	$96.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.87 / $107.38 / $198.88	Professional	TC	$49.87	$107.38	$198.88
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $113.50 / $130.38 / $161.72	Professional		$113.50	$130.38	$161.72
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $38.79 / $51.56 / $96.31	Professional	26	$38.79	$51.56	$96.31
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $75.95 / $78.97 / $107.05	Professional	TC	$75.95	$78.97	$107.05
Health New England Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $84.47 / $233.82	Professional		$64.48	$84.47	$233.82
United Facility/Professional Professional Modifier Low / Median / High Price $96.92 / $153.27 / $274.16	Professional		$96.92	$153.27	$274.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.47 / $55.68 / $99.59	Professional	26	$36.47	$55.68	$99.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.46 / $97.83 / $174.57	Professional	TC	$56.46	$97.83	$174.57