Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.95 / $381.01 / $496.42	Facility	26	$166.95	$381.01	$496.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $396.12 / $600.00 / $1,659.20	Professional		$396.12	$600.00	$1,659.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $166.95 / $406.00	Professional	26	$111.15	$166.95	$406.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $433.05 / $1,045.09	Professional	TC	$259.35	$433.05	$1,045.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $372.98 / $874.45 / $1,027.34	Professional		$372.98	$874.45	$1,027.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $110.65 / $252.42 / $311.61	Professional	26	$110.65	$252.42	$311.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $262.64 / $615.04 / $733.31	Professional	TC	$262.64	$615.04	$733.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $456.01 / $615.74 / $1,141.61	Professional		$456.01	$615.74	$1,141.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.73 / $155.41 / $286.27	Professional	26	$123.73	$155.41	$286.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $327.10 / $451.11 / $804.89	Professional	TC	$327.10	$451.11	$804.89
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $393.56 / $502.44 / $827.24	Professional		$393.56	$502.44	$827.24
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $101.63 / $124.14 / $248.54	Professional	26	$101.63	$124.14	$248.54
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $271.95 / $281.55 / $482.39	Professional	TC	$271.95	$281.55	$482.39
Health New England Facility/Professional Professional Modifier Low / Median / High Price $211.30 / $337.68 / $1,032.50	Professional		$211.30	$337.68	$1,032.50
United Facility/Professional Professional Modifier Low / Median / High Price $353.94 / $704.93 / $1,380.03	Professional		$353.94	$704.93	$1,380.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.54 / $164.71 / $369.59	Professional	26	$80.54	$164.71	$369.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $277.11 / $525.54 / $1,260.09	Professional	TC	$277.11	$525.54	$1,260.09