Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.69 / $158.19 / $215.76	Facility	26	$51.69	$158.19	$215.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.61 / $264.05 / $413.17	Professional		$189.61	$264.05	$413.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.46 / $51.69 / $176.34	Professional	26	$35.46	$51.69	$176.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.15 / $212.36 / $337.75	Professional	TC	$154.15	$212.36	$337.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.54 / $403.54 / $478.79	Professional		$218.54	$403.54	$478.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.62 / $77.48 / $91.94	Professional	26	$44.62	$77.48	$91.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.92 / $326.04 / $386.84	Professional	TC	$173.92	$326.04	$386.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.94 / $366.30 / $576.84	Professional		$288.94	$366.30	$576.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.03 / $64.89 / $106.80	Professional	26	$58.03	$64.89	$106.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $236.30 / $319.06 / $476.53	Professional	TC	$236.30	$319.06	$476.53
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $241.97 / $259.30 / $344.11	Professional		$241.97	$259.30	$344.11
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $45.41 / $47.21 / $51.27	Professional	26	$45.41	$47.21	$51.27
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $190.70 / $204.02 / $212.09	Professional	TC	$190.70	$204.02	$212.09
Health New England Facility/Professional Professional Modifier Low / Median / High Price $68.00 / $68.00 / $68.00	Professional		$68.00	$68.00	$68.00
United Facility/Professional Professional Modifier Low / Median / High Price $219.70 / $345.79 / $612.28	Professional		$219.70	$345.79	$612.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.49 / $70.39 / $124.80	Professional	26	$38.49	$70.39	$124.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $178.80 / $279.35 / $438.71	Professional	TC	$178.80	$279.35	$438.71