Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.75 / $195.74 / $262.88	Facility	26	$63.75	$195.74	$262.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.76 / $201.42 / $924.00	Professional		$140.76	$201.42	$924.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.95 / $63.75 / $191.01	Professional	26	$43.95	$63.75	$191.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.81 / $137.66 / $307.29	Professional	TC	$96.81	$137.66	$307.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.20 / $261.76 / $296.69	Professional		$185.20	$261.76	$296.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.89 / $83.59 / $97.55	Professional	26	$55.89	$83.59	$97.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.80 / $175.69 / $199.14	Professional	TC	$128.80	$175.69	$199.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.28 / $323.29 / $427.72	Professional		$239.28	$323.29	$427.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.06 / $79.63 / $129.88	Professional	26	$70.06	$79.63	$129.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.21 / $243.66 / $300.77	Professional	TC	$169.21	$243.66	$300.77
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $176.60 / $205.33 / $290.41	Professional		$176.60	$205.33	$290.41
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $54.69 / $56.86 / $63.03	Professional	26	$54.69	$56.86	$63.03
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $121.91 / $126.74 / $142.30	Professional	TC	$121.91	$126.74	$142.30
Health New England Facility/Professional Professional Modifier Low / Median / High Price $78.18 / $84.68 / $173.19	Professional		$78.18	$84.68	$173.19
United Facility/Professional Professional Modifier Low / Median / High Price $173.57 / $289.06 / $423.96	Professional		$173.57	$289.06	$423.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.24 / $85.76 / $152.47	Professional	26	$47.24	$85.76	$152.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.52 / $184.20 / $344.71	Professional	TC	$122.52	$184.20	$344.71