Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $616.60 / $724.44	Facility	26	$213.80	$616.60	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,230.27 / $4,365.16	Professional		$741.31	$1,230.27	$4,365.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $208.93 / $851.14	Professional	26	$109.65	$208.93	$851.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $245.47 / $1,479.11 / $3,630.78	Professional	52	$245.47	$1,479.11	$3,630.78
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $549.54 / $676.08 / $676.08	Professional	53	$549.54	$676.08	$676.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $758.58 / $1,698.24	Professional	TC	$588.84	$758.58	$1,698.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,380.38 / $2,137.96	Professional		$741.31	$1,380.38	$2,137.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $239.88 / $436.52	Professional	26	$102.33	$239.88	$436.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $1,096.48 / $1,698.24	Professional	TC	$630.96	$1,096.48	$1,698.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,445.44 / $2,454.71	Professional		$851.14	$1,445.44	$2,454.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $251.19 / $371.54	Professional	26	$134.90	$251.19	$371.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $1,174.90 / $1,995.26	Professional	TC	$660.69	$1,174.90	$1,995.26
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,380.38 / $1,659.59	Professional		$954.99	$1,380.38	$1,659.59
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $190.55 / $288.40	Professional	26	$138.04	$190.55	$288.40
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $831.76 / $1,096.48 / $1,412.54	Professional	TC	$831.76	$1,096.48	$1,412.54
Health New England Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $1,548.82 / $1,548.82	Professional		$229.09	$1,548.82	$1,548.82
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,174.90 / $2,137.96	Professional		$776.25	$1,174.90	$2,137.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $194.98 / $338.84	Professional	26	$112.20	$194.98	$338.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $1,000.00 / $1,862.09	Professional	TC	$660.69	$1,000.00	$1,862.09