Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.74 / $113.95 / $145.71	Facility	26	$35.74	$113.95	$145.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.73 / $186.28 / $616.00	Professional		$105.73	$186.28	$616.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.53 / $42.94 / $168.21	Professional	26	$30.53	$42.94	$168.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.06 / $96.81 / $208.79	Professional	TC	$49.06	$96.81	$208.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.23 / $190.20 / $287.39	Professional		$126.23	$190.20	$287.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.74 / $44.56 / $57.90	Professional	26	$29.74	$44.56	$57.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.43 / $140.60 / $243.41	Professional	TC	$97.43	$140.60	$243.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.19 / $212.61 / $498.08	Professional		$120.19	$212.61	$498.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.19 / $45.15 / $75.29	Professional	26	$36.19	$45.15	$75.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.55 / $218.85 / $452.94	Professional	TC	$76.55	$218.85	$452.94
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $163.38 / $193.09	Professional		$139.21	$163.38	$193.09
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $32.60 / $35.18 / $50.88	Professional	26	$32.60	$35.18	$50.88
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $106.62 / $124.74 / $155.38	Professional	TC	$106.62	$124.74	$155.38
Health New England Facility/Professional Professional Modifier Low / Median / High Price $48.75 / $180.02 / $1,090.00	Professional		$48.75	$180.02	$1,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $126.92 / $214.69 / $409.11	Professional		$126.92	$214.69	$409.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.70 / $44.02 / $78.73	Professional	26	$28.70	$44.02	$78.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.72 / $181.71 / $347.28	Professional	TC	$98.72	$181.71	$347.28