Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $113.83 / $150.05	Facility	26	$37.43	$113.83	$150.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.47 / $164.38 / $657.00	Professional		$91.47	$164.38	$657.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $37.43 / $172.84	Professional	26	$29.75	$37.43	$172.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.86 / $94.28 / $441.00	Professional	TC	$61.86	$94.28	$441.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.56 / $157.74 / $203.75	Professional		$105.56	$157.74	$203.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.59 / $44.04 / $56.74	Professional	26	$31.59	$44.04	$56.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.31 / $112.95 / $147.78	Professional	TC	$73.31	$112.95	$147.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.72 / $168.73 / $268.04	Professional		$119.72	$168.73	$268.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.26 / $45.97 / $77.12	Professional	26	$37.26	$45.97	$77.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.54 / $118.89 / $199.00	Professional	TC	$72.54	$118.89	$199.00
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $118.22 / $141.22 / $181.52	Professional		$118.22	$141.22	$181.52
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $31.59 / $36.86 / $63.24	Professional	26	$31.59	$36.86	$63.24
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $82.60 / $94.49 / $141.91	Professional	TC	$82.60	$94.49	$141.91
Health New England Facility/Professional Professional Modifier Low / Median / High Price $50.30 / $102.56 / $229.77	Professional		$50.30	$102.56	$229.77
United Facility/Professional Professional Modifier Low / Median / High Price $88.56 / $149.35 / $265.41	Professional		$88.56	$149.35	$265.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.77 / $45.11 / $80.48	Professional	26	$28.77	$45.11	$80.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.41 / $104.28 / $185.97	Professional	TC	$65.41	$104.28	$185.97