Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $269.15 / $331.13	Facility	26	$93.33	$269.15	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $602.56	Professional		$131.83	$177.83	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $223.87	Professional	26	$54.95	$83.18	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $100.00 / $239.88	Professional	TC	$66.07	$100.00	$239.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $204.17 / $323.59	Professional		$95.50	$204.17	$323.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $87.10 / $141.25	Professional	26	$45.71	$87.10	$141.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $117.49 / $177.83	Professional	TC	$50.12	$117.49	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $295.12 / $501.19	Professional		$151.36	$295.12	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $87.10 / $162.18	Professional	26	$58.88	$87.10	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $162.18 / $389.05	Professional	TC	$67.61	$162.18	$389.05
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $263.03 / $501.19	Professional		$158.49	$263.03	$501.19
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $89.13 / $109.65	Professional	26	$58.88	$89.13	$109.65
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $87.10 / $144.54	Professional	TC	$67.61	$87.10	$144.54
Health New England Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $151.36	Professional		$97.72	$123.03	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $199.53 / $389.05	Professional		$128.82	$199.53	$389.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $79.43 / $151.36	Professional	26	$53.70	$79.43	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $104.71 / $223.87	Professional	TC	$66.07	$104.71	$223.87