Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $190.55 / $269.15	Facility	26	$57.54	$190.55	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $186.21 / $741.31	Professional		$120.23	$186.21	$741.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $53.70 / $144.54	Professional	26	$39.81	$53.70	$144.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.15 / $37.15 / $37.15	Professional	52	$37.15	$37.15	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $125.89 / $371.54	Professional	TC	$95.50	$125.89	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $239.88 / $363.08	Professional		$131.83	$239.88	$363.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $66.07 / $97.72	Professional	26	$37.15	$66.07	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $177.83 / $257.04	Professional	TC	$93.33	$177.83	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $245.47 / $426.58	Professional		$165.96	$245.47	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $67.61 / $117.49	Professional	26	$46.77	$67.61	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $177.83 / $316.23	Professional	TC	$114.82	$177.83	$316.23
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $223.87 / $380.19	Professional		$186.21	$223.87	$380.19
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $134.90 / $173.78	Professional	26	$54.95	$134.90	$173.78
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $177.83 / $223.87	Professional	TC	$141.25	$177.83	$223.87
Health New England Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $97.72 / $338.84	Professional		$66.07	$97.72	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $208.93 / $371.54	Professional		$144.54	$208.93	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $57.54 / $104.71	Professional	26	$38.90	$57.54	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $151.36 / $251.19	Professional	TC	$102.33	$151.36	$251.19