Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $64.57 / $107.15	Professional		$46.77	$64.57	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.70 / $33.11	Professional	26	$19.05	$25.70	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $60.26	Professional	TC	$25.70	$37.15	$60.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $107.15 / $134.90	Professional		$51.29	$107.15	$134.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $34.67 / $41.69	Professional	26	$20.42	$34.67	$41.69
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $75.86 / $154.88 / $199.53	Professional	50	$75.86	$154.88	$199.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $74.13 / $93.33	Professional	TC	$30.20	$74.13	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $91.20 / $158.49	Professional		$52.48	$91.20	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $33.11 / $70.79	Professional	26	$20.42	$33.11	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $58.88 / $102.33	Professional	TC	$29.51	$58.88	$102.33
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $56.23 / $107.15	Professional		$44.67	$56.23	$107.15
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $34.67 / $42.66	Professional	26	$30.90	$34.67	$42.66
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $61.66 / $64.57	Professional	TC	$44.67	$61.66	$64.57
Health New England Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $134.90	Professional		$61.66	$61.66	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $64.57 / $117.49	Professional		$48.98	$64.57	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.30 / $50.12	Professional	26	$19.05	$26.30	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.02 / $69.18	Professional	TC	$28.18	$38.02	$69.18