Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.27 / $125.64 / $163.97	Facility	26	$41.27	$125.64	$163.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.95 / $160.63 / $530.00	Professional		$88.95	$160.63	$530.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.13 / $54.52 / $197.89	Professional	26	$32.13	$54.52	$197.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.18 / $67.59 / $209.56	Professional	TC	$48.18	$67.59	$209.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.86 / $142.38 / $181.72	Professional		$92.86	$142.38	$181.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.14 / $53.84 / $67.70	Professional	26	$35.14	$53.84	$67.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.46 / $89.40 / $114.73	Professional	TC	$57.46	$89.40	$114.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.58 / $146.97 / $231.40	Professional		$107.58	$146.97	$231.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.72 / $50.12 / $84.89	Professional	26	$40.72	$50.12	$84.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.22 / $93.47 / $163.81	Professional	TC	$64.22	$93.47	$163.81
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $103.22 / $119.03 / $148.80	Professional		$103.22	$119.03	$148.80
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $34.08 / $45.89 / $88.13	Professional	26	$34.08	$45.89	$88.13
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $64.29 / $69.75 / $94.57	Professional	TC	$64.29	$69.75	$94.57
Health New England Facility/Professional Professional Modifier Low / Median / High Price $56.30 / $75.01 / $205.72	Professional		$56.30	$75.01	$205.72
United Facility/Professional Professional Modifier Low / Median / High Price $83.63 / $130.55 / $232.03	Professional		$83.63	$130.55	$232.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.55 / $48.58 / $103.97	Professional	26	$31.55	$48.58	$103.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.08 / $81.38 / $145.66	Professional	TC	$52.08	$81.38	$145.66