Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.68 / $93.67 / $316.75	Professional		$43.68	$93.67	$316.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $12.56 / $62.35	Professional	26	$7.54	$12.56	$62.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.13 / $59.13 / $88.72	Professional	TC	$36.13	$59.13	$88.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.48 / $102.60 / $142.38	Professional		$86.48	$102.60	$142.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.21 / $17.54 / $22.43	Professional	26	$13.21	$17.54	$22.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.25 / $84.96 / $123.09	Professional	TC	$71.25	$84.96	$123.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.56 / $41.56 / $41.56	Facility		$41.56	$41.56	$41.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.77 / $78.47 / $167.99	Professional		$32.77	$78.47	$167.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.18 / $14.05 / $24.04	Professional	26	$6.18	$14.05	$24.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.67 / $62.99 / $137.22	Professional	TC	$25.67	$62.99	$137.22
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $20.88 / $84.67 / $143.96	Professional		$20.88	$84.67	$143.96
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $10.19 / $19.84 / $27.74	Professional	26	$10.19	$19.84	$27.74
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $52.88 / $107.65 / $142.32	Professional	TC	$52.88	$107.65	$142.32
Health New England Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $108.19 / $174.50	Professional		$25.00	$108.19	$174.50
United Facility/Professional Professional Modifier Low / Median / High Price $46.87 / $122.97 / $208.17	Professional		$46.87	$122.97	$208.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $20.21 / $38.47	Professional	26	$7.92	$20.21	$38.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.95 / $96.70 / $175.33	Professional	TC	$35.95	$96.70	$175.33