Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.70 / $80.73 / $166.43	Facility		$38.70	$80.73	$166.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.47 / $54.81 / $64.50	Facility	26	$15.47	$54.81	$64.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $34.72 / $75.08	Professional		$30.91	$34.72	$75.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.89 / $15.47 / $76.33	Professional	26	$10.89	$15.47	$76.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $20.28 / $46.85	Professional	TC	$17.89	$20.28	$46.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.57 / $52.65 / $81.91	Facility		$36.57	$52.65	$81.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.81 / $48.51 / $62.67	Professional		$35.81	$48.51	$62.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $19.61 / $23.91	Professional	26	$12.96	$19.61	$23.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.50 / $30.16 / $39.90	Professional	TC	$22.50	$30.16	$39.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.67 / $103.86 / $685.85	Facility		$51.67	$103.86	$685.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.14 / $57.09 / $165.00	Professional		$39.14	$57.09	$165.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.87 / $20.98 / $37.00	Professional	26	$15.87	$20.98	$37.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.43 / $40.69 / $76.79	Professional	TC	$20.43	$40.69	$76.79
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $35.50 / $41.58 / $51.10	Professional		$35.50	$41.58	$51.10
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $14.08 / $14.70 / $23.85	Professional	26	$14.08	$14.70	$23.85
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $20.09 / $28.56 / $35.49	Professional	TC	$20.09	$28.56	$35.49
Health New England Facility/Professional Facility Modifier Low / Median / High Price $72.72 / $96.29 / $1,130.48	Facility		$72.72	$96.29	$1,130.48
Health New England Facility/Professional Professional Modifier Low / Median / High Price $22.03 / $30.73 / $55.13	Professional		$22.03	$30.73	$55.13
United Facility/Professional Professional Modifier Low / Median / High Price $29.36 / $49.39 / $88.34	Professional		$29.36	$49.39	$88.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.44 / $18.66 / $33.96	Professional	26	$12.44	$18.66	$33.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.70 / $32.35 / $54.38	Professional	TC	$19.70	$32.35	$54.38