Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.66 / $330.33 / $456.24	Facility	26	$109.66	$330.33	$456.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $787.50 / $1,053.75 / $2,625.29	Professional		$787.50	$1,053.75	$2,625.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.68 / $109.66 / $511.74	Professional	26	$78.68	$109.66	$511.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $708.82 / $944.09 / $2,124.51	Professional	TC	$708.82	$944.09	$2,124.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $876.92 / $2,293.27 / $2,720.86	Professional		$876.92	$2,293.27	$2,720.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.25 / $251.15 / $297.97	Professional	26	$90.25	$251.15	$297.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $779.91 / $2,042.12 / $2,422.88	Professional	TC	$779.91	$2,042.12	$2,422.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,189.69 / $1,454.27 / $2,440.51	Professional		$1,189.69	$1,454.27	$2,440.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.83 / $138.13 / $247.49	Professional	26	$121.83	$138.13	$247.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,064.00 / $1,307.94 / $2,186.71	Professional	TC	$1,064.00	$1,307.94	$2,186.71
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $942.28 / $1,231.38 / $1,293.60	Professional		$942.28	$1,231.38	$1,293.60
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $108.48 / $108.48 / $108.48	Professional	26	$108.48	$108.48	$108.48
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $833.79 / $833.79 / $833.79	Professional	TC	$833.79	$833.79	$833.79
Health New England Facility/Professional Professional Modifier Low / Median / High Price $138.31 / $147.80 / $151.55	Professional		$138.31	$147.80	$151.55
United Facility/Professional Professional Modifier Low / Median / High Price $813.18 / $1,337.91 / $2,246.32	Professional		$813.18	$1,337.91	$2,246.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.95 / $148.84 / $266.00	Professional	26	$81.95	$148.84	$266.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $731.23 / $1,239.49 / $2,181.28	Professional	TC	$731.23	$1,239.49	$2,181.28