Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.83 / $90.23 / $266.01	Professional		$45.83	$90.23	$266.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.66 / $40.84 / $168.72	Professional	26	$21.66	$40.84	$168.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.92 / $32.50 / $56.18	Professional	52	$22.92	$32.50	$56.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.00 / $43.34 / $93.29	Professional	TC	$22.00	$43.34	$93.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.61 / $120.99 / $183.67	Professional		$82.61	$120.99	$183.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.68 / $54.71 / $80.09	Professional	26	$40.68	$54.71	$80.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.15 / $84.93 / $112.02	Professional	TC	$42.15	$84.93	$112.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.84 / $67.84 / $67.84	Facility		$67.84	$67.84	$67.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.22 / $94.02 / $197.64	Professional		$40.22	$94.02	$197.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.47 / $43.36 / $84.53	Professional	26	$19.47	$43.36	$84.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.97 / $44.73 / $85.04	Professional	TC	$18.97	$44.73	$85.04
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $63.59 / $135.44 / $208.47	Professional		$63.59	$135.44	$208.47
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $36.86 / $76.56 / $121.23	Professional	26	$36.86	$76.56	$121.23
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $31.32 / $62.28 / $115.89	Professional	TC	$31.32	$62.28	$115.89
Health New England Facility/Professional Professional Modifier Low / Median / High Price $73.92 / $157.63 / $701.49	Professional		$73.92	$157.63	$701.49
United Facility/Professional Professional Modifier Low / Median / High Price $45.36 / $117.04 / $281.70	Professional		$45.36	$117.04	$281.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.83 / $67.45 / $131.13	Professional	26	$22.83	$67.45	$131.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $64.06 / $215.38	Professional	TC	$19.64	$64.06	$215.38