Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.49 / $314.19 / $719.56	Facility	26	$213.49	$314.19	$719.56
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $242.23 / $453.15 / $858.79	Facility	53	$242.23	$453.15	$858.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $866.67 / $1,582.05 / $4,833.00	Professional		$866.67	$1,582.05	$4,833.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $162.72 / $228.77 / $1,043.00	Professional	26	$162.72	$228.77	$1,043.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $390.85 / $605.58 / $2,926.72	Professional	52	$390.85	$605.58	$2,926.72
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $156.34 / $242.23 / $679.83	Professional	53	$156.34	$242.23	$679.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $687.63 / $997.68 / $2,132.98	Professional	TC	$687.63	$997.68	$2,132.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $772.45 / $1,643.25 / $2,322.56	Professional		$772.45	$1,643.25	$2,322.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $103.39 / $341.49 / $452.76	Professional	26	$103.39	$341.49	$452.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $664.50 / $1,301.75 / $1,839.89	Professional	TC	$664.50	$1,301.75	$1,839.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $889.24 / $1,434.29 / $2,258.59	Professional		$889.24	$1,434.29	$2,258.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $135.43 / $253.77 / $370.26	Professional	26	$135.43	$253.77	$370.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $743.08 / $1,199.67 / $1,959.03	Professional	TC	$743.08	$1,199.67	$1,959.03
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $817.71 / $1,168.95 / $1,864.50	Professional		$817.71	$1,168.95	$1,864.50
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $125.43 / $179.32 / $288.45	Professional	26	$125.43	$179.32	$288.45
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $692.27 / $989.64 / $1,492.50	Professional	TC	$692.27	$989.64	$1,492.50
Health New England Facility/Professional Professional Modifier Low / Median / High Price $169.05 / $350.26 / $368.05	Professional		$169.05	$350.26	$368.05
United Facility/Professional Professional Modifier Low / Median / High Price $877.92 / $1,430.27 / $2,595.21	Professional		$877.92	$1,430.27	$2,595.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $132.09 / $232.80 / $350.66	Professional	26	$132.09	$232.80	$350.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $747.01 / $1,182.48 / $2,055.71	Professional	TC	$747.01	$1,182.48	$2,055.71