Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $81.28 / $117.49	Facility		$54.95	$81.28	$117.49
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $54.95 / $66.07	Facility	26	$17.38	$54.95	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.90 / $102.33	Professional		$25.70	$38.90	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.98 / $67.61	Professional	26	$10.96	$16.98	$67.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.91 / $52.48	Professional	TC	$15.85	$22.91	$52.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $64.57 / $87.10	Facility		$38.90	$64.57	$87.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $79.43	Professional		$34.67	$46.77	$79.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $18.20 / $28.18	Professional	26	$12.88	$18.20	$28.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $27.54 / $43.65	Professional	TC	$21.88	$27.54	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $91.20 / $537.03	Facility		$38.02	$91.20	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $56.23 / $134.90	Professional		$34.67	$56.23	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $20.89 / $40.74	Professional	26	$14.79	$20.89	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $32.36 / $81.28	Professional	TC	$19.95	$32.36	$81.28
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $43.65 / $54.95	Professional		$37.15	$43.65	$54.95
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $18.62 / $23.99	Professional	26	$14.13	$18.62	$23.99
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $32.36 / $46.77	Professional	TC	$19.95	$32.36	$46.77
Health New England Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $74.13 / $1,122.02	Facility		$72.44	$74.13	$1,122.02
Health New England Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $24.55 / $54.95	Professional		$19.95	$24.55	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $40.74 / $77.62	Professional		$28.18	$40.74	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.49 / $28.84	Professional	26	$10.96	$15.49	$28.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $24.55 / $51.29	Professional	TC	$17.38	$24.55	$51.29