Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $114.82 / $158.49	Facility	26	$36.31	$114.82	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $281.84	Professional		$85.11	$123.03	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.90 / $70.79	Professional	26	$22.91	$30.90	$70.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $77.62 / $169.82	Professional	TC	$60.26	$77.62	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $213.80	Professional		$107.15	$151.36	$213.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $40.74 / $58.88	Professional	26	$28.84	$40.74	$58.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $109.65 / $154.88	Professional	TC	$79.43	$109.65	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $154.88 / $281.84	Professional		$112.20	$154.88	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $40.74 / $75.86	Professional	26	$30.90	$40.74	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $114.82 / $208.93	Professional	TC	$83.18	$114.82	$208.93
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $138.04 / $177.83	Professional		$114.82	$138.04	$177.83
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $38.90 / $47.86	Professional	26	$26.30	$38.90	$47.86
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $114.82 / $144.54	Professional	TC	$74.13	$114.82	$144.54
Health New England Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $46.77 / $72.44	Professional		$39.81	$46.77	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $120.23 / $213.80	Professional		$87.10	$120.23	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $31.62 / $56.23	Professional	26	$22.39	$31.62	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $87.10 / $158.49	Professional	TC	$63.10	$87.10	$158.49