Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.26 / $122.16 / $162.21	Facility	26	$39.26	$122.16	$162.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.36 / $384.76 / $1,646.00	Professional		$276.36	$384.76	$1,646.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.39 / $39.26 / $120.30	Professional	26	$30.39	$39.26	$120.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.34 / $345.50 / $664.23	Professional	TC	$249.34	$345.50	$664.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $307.97 / $574.12 / $738.99	Professional		$307.97	$574.12	$738.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.47 / $61.28 / $79.62	Professional	26	$32.47	$61.28	$79.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $275.49 / $512.84 / $660.11	Professional	TC	$275.49	$512.84	$660.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $417.29 / $498.18 / $783.34	Professional		$417.29	$498.18	$783.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.25 / $49.80 / $77.47	Professional	26	$43.25	$49.80	$77.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $375.01 / $447.53 / $706.92	Professional	TC	$375.01	$447.53	$706.92
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $325.68 / $341.25 / $471.57	Professional		$325.68	$341.25	$471.57
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $32.04 / $33.33 / $39.18	Professional	26	$32.04	$33.33	$39.18
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $293.62 / $302.07 / $305.24	Professional	TC	$293.62	$302.07	$305.24
Health New England Facility/Professional Professional Modifier Low / Median / High Price $48.80 / $54.20 / $112.50	Professional		$48.80	$54.20	$112.50
United Facility/Professional Professional Modifier Low / Median / High Price $296.42 / $490.09 / $876.07	Professional		$296.42	$490.09	$876.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.09 / $52.92 / $95.25	Professional	26	$29.09	$52.92	$95.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $267.33 / $453.79 / $712.66	Professional	TC	$267.33	$453.79	$712.66