Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.06 / $83.98 / $153.16	Professional		$55.06	$83.98	$153.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.72 / $51.10 / $140.22	Professional	26	$34.72	$51.10	$140.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.34 / $35.96 / $46.72	Professional	TC	$20.34	$35.96	$46.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.97 / $140.62 / $168.32	Professional		$104.97	$140.62	$168.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.15 / $90.41 / $114.13	Professional	26	$67.15	$90.41	$114.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.82 / $52.82 / $63.46	Professional	TC	$37.82	$52.82	$63.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.91 / $94.75 / $182.71	Professional		$48.91	$94.75	$182.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.87 / $63.73 / $126.36	Professional	26	$31.87	$63.73	$126.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $26.86 / $66.52	Professional	TC	$12.88	$26.86	$66.52
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $150.08 / $300.00	Professional		$75.00	$150.08	$300.00
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $52.01 / $103.27 / $144.36	Professional	26	$52.01	$103.27	$144.36
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $28.32 / $48.07 / $62.06	Professional	TC	$28.32	$48.07	$62.06
Health New England Facility/Professional Professional Modifier Low / Median / High Price $52.12 / $125.70 / $132.85	Professional		$52.12	$125.70	$132.85
United Facility/Professional Professional Modifier Low / Median / High Price $58.12 / $142.53 / $275.52	Professional		$58.12	$142.53	$275.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.76 / $106.05 / $179.21	Professional	26	$40.76	$106.05	$179.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.87 / $39.97 / $85.85	Professional	TC	$12.87	$39.97	$85.85