Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $115.07 / $150.05	Facility	26	$37.43	$115.07	$150.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.34 / $198.19 / $505.00	Professional		$113.34	$198.19	$505.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.70 / $37.43 / $124.15	Professional	26	$29.70	$37.43	$124.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $48.69 / $68.50 / $337.50	Professional	52	$48.69	$68.50	$337.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.91 / $99.56 / $260.00	Professional	TC	$71.91	$99.56	$260.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.37 / $169.63 / $219.45	Professional		$116.37	$169.63	$219.45
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.59 / $44.52 / $57.32	Professional	26	$31.59	$44.52	$57.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.20 / $125.11 / $161.77	Professional	TC	$83.20	$125.11	$161.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.72 / $184.52 / $296.62	Professional		$119.72	$184.52	$296.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.26 / $46.02 / $77.93	Professional	26	$37.26	$46.02	$77.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.54 / $128.07 / $234.12	Professional	TC	$72.54	$128.07	$234.12
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $123.30 / $137.72 / $174.15	Professional		$123.30	$137.72	$174.15
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $31.59 / $36.00 / $50.88	Professional	26	$31.59	$36.00	$50.88
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $91.97 / $97.04 / $129.62	Professional	TC	$91.97	$97.04	$129.62
Health New England Facility/Professional Professional Modifier Low / Median / High Price $50.83 / $68.25 / $260.85	Professional		$50.83	$68.25	$260.85
United Facility/Professional Professional Modifier Low / Median / High Price $106.29 / $165.66 / $299.77	Professional		$106.29	$165.66	$299.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.77 / $46.46 / $81.36	Professional	26	$28.77	$46.46	$81.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.31 / $120.33 / $218.42	Professional	TC	$66.31	$120.33	$218.42