Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.56 / $165.92 / $202.49	Facility	26	$129.56	$165.92	$202.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.73 / $277.35 / $799.14	Professional		$177.73	$277.35	$799.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.02 / $92.58 / $266.93	Professional	26	$64.02	$92.58	$266.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.71 / $177.79 / $532.16	Professional	TC	$113.71	$177.79	$532.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.52 / $212.59 / $252.23	Professional		$126.52	$212.59	$252.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.74 / $64.86 / $76.14	Professional	26	$45.74	$64.86	$76.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.77 / $150.63 / $178.71	Professional	TC	$80.77	$150.63	$178.71
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $139.36 / $210.72 / $231.11	Professional		$139.36	$210.72	$231.11
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $43.75 / $44.92 / $51.94	Professional	26	$43.75	$44.92	$51.94
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $84.44 / $87.42 / $171.44	Professional	TC	$84.44	$87.42	$171.44
Health New England Facility/Professional Professional Modifier Low / Median / High Price $115.79 / $138.36 / $138.36	Professional		$115.79	$138.36	$138.36
United Facility/Professional Professional Modifier Low / Median / High Price $118.29 / $198.30 / $369.64	Professional		$118.29	$198.30	$369.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.06 / $64.67 / $132.72	Professional	26	$39.06	$64.67	$132.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.79 / $138.99 / $236.92	Professional	TC	$82.79	$138.99	$236.92