Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $138.04 / $138.04	Facility		$104.71	$138.04	$138.04
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $147.91 / $173.78	Facility	26	$34.67	$147.91	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $83.18 / $295.12	Professional		$40.74	$83.18	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $39.81 / $128.82	Professional	26	$25.70	$39.81	$128.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $63.10 / $208.93 / $398.11	Professional	50	$63.10	$208.93	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $38.90 / $169.82	Professional	TC	$15.14	$38.90	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $102.33 / $162.18	Professional		$52.48	$102.33	$162.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $40.74 / $56.23	Professional	26	$30.90	$40.74	$56.23
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $151.36 / $223.87	Professional	50	$77.62	$151.36	$223.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $60.26 / $107.15	Professional	TC	$19.50	$60.26	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $165.96 / $467.74	Facility		$144.54	$165.96	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $107.15 / $181.97	Professional		$60.26	$107.15	$181.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $41.69 / $91.20	Professional	26	$30.90	$41.69	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $64.57 / $104.71	Professional	TC	$21.38	$64.57	$104.71
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $95.50 / $138.04	Professional		$57.54	$95.50	$138.04
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $45.71 / $58.88	Professional	26	$35.48	$45.71	$58.88
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $36.31 / $91.20	Professional	TC	$21.88	$36.31	$91.20
Health New England Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $75.86 / $120.23	Professional		$48.98	$75.86	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.11 / $60.26	Professional	26	$23.44	$33.11	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $38.02 / $69.18	Professional	TC	$19.95	$38.02	$69.18