Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.59 / $146.06 / $171.88	Facility	26	$39.59	$146.06	$171.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.05 / $229.39 / $757.00	Professional		$110.05	$229.39	$757.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.71 / $40.43 / $118.03	Professional	26	$32.71	$40.43	$118.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $42.68 / $282.39 / $633.00	Professional	52	$42.68	$282.39	$633.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.29 / $111.95 / $534.00	Professional	TC	$82.29	$111.95	$534.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.30 / $229.54 / $289.70	Professional		$115.30	$229.54	$289.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.16 / $61.02 / $72.70	Professional	26	$31.16	$61.02	$72.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.14 / $169.22 / $217.00	Professional	TC	$84.14	$169.22	$217.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.69 / $197.38 / $316.22	Professional		$151.69	$197.38	$316.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.99 / $50.01 / $83.81	Professional	26	$40.99	$50.01	$83.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.70 / $146.38 / $252.47	Professional	TC	$110.70	$146.38	$252.47
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $144.30 / $208.00 / $350.15	Professional		$144.30	$208.00	$350.15
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $39.70 / $128.38 / $141.85	Professional	26	$39.70	$128.38	$141.85
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $105.35 / $188.61 / $208.36	Professional	TC	$105.35	$188.61	$208.36
Health New England Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $115.50 / $356.37	Professional		$54.00	$115.50	$356.37
United Facility/Professional Professional Modifier Low / Median / High Price $118.41 / $195.03 / $342.41	Professional		$118.41	$195.03	$342.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.49 / $54.73 / $100.74	Professional	26	$33.49	$54.73	$100.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.59 / $139.94 / $249.65	Professional	TC	$87.59	$139.94	$249.65