Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $88.98 / $126.15	Professional		$45.00	$88.98	$126.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.30 / $36.65 / $63.20	Professional	26	$17.30	$36.65	$63.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.69 / $41.18 / $77.11	Professional	TC	$27.69	$41.18	$77.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.48 / $115.35 / $177.75	Professional		$74.48	$115.35	$177.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.13 / $73.93 / $96.07	Professional	26	$30.13	$73.93	$96.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.84 / $65.84 / $80.31	Professional	TC	$48.84	$65.84	$80.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.86 / $73.86 / $73.86	Facility		$73.86	$73.86	$73.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $82.31 / $149.77	Professional		$37.20	$82.31	$149.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.34 / $34.86 / $101.01	Professional	26	$15.34	$34.86	$101.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.27 / $46.68 / $88.03	Professional	TC	$22.27	$46.68	$88.03
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $60.28 / $101.32 / $161.99	Professional		$60.28	$101.32	$161.99
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $19.30 / $48.28 / $101.50	Professional	26	$19.30	$48.28	$101.50
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $30.84 / $62.84 / $86.42	Professional	TC	$30.84	$62.84	$86.42
Health New England Facility/Professional Professional Modifier Low / Median / High Price $27.35 / $168.44 / $252.15	Professional		$27.35	$168.44	$252.15
Health New England Facility/Professional Professional Modifier 26 Low / Median / High Price $27.35 / $27.35 / $27.35	Professional	26	$27.35	$27.35	$27.35
United Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $109.71 / $200.72	Professional		$67.56	$109.71	$200.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.87 / $47.03 / $78.44	Professional	26	$28.87	$47.03	$78.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.71 / $63.75 / $122.28	Professional	TC	$32.71	$63.75	$122.28