Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.11 / $285.33 / $307.43	Facility		$77.11	$285.33	$307.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.77 / $52.22 / $120.17	Facility	26	$24.77	$52.22	$120.17
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $52.34 / $285.33 / $307.43	Facility	TC	$52.34	$285.33	$307.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.82 / $80.16 / $275.55	Professional		$32.82	$80.16	$275.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.21 / $30.25 / $98.18	Professional	26	$23.21	$30.25	$98.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $234.74 / $281.35 / $435.00	Professional	50	$234.74	$281.35	$435.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.47 / $40.33 / $158.84	Professional	52	$33.47	$40.33	$158.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.45 / $55.64 / $153.22	Professional	TC	$30.45	$55.64	$153.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.01 / $91.39 / $121.79	Professional		$33.01	$91.39	$121.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.79 / $30.53 / $39.22	Professional	26	$17.79	$30.53	$39.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $49.49 / $131.16 / $177.75	Professional	50	$49.49	$131.16	$177.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.22 / $63.78 / $84.99	Professional	TC	$15.22	$63.78	$84.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.72 / $199.40 / $430.50	Facility		$114.72	$199.40	$430.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.72 / $94.41 / $144.13	Professional		$43.72	$94.41	$144.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.40 / $28.85 / $57.76	Professional	26	$23.40	$28.85	$57.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.35 / $65.73 / $98.33	Professional	TC	$20.35	$65.73	$98.33
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $188.75 / $216.03	Professional		$55.09	$188.75	$216.03
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $23.21 / $28.59 / $48.75	Professional	26	$23.21	$28.59	$48.75
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $19.34 / $27.64 / $67.37	Professional	TC	$19.34	$27.64	$67.37
Health New England Facility/Professional Professional Modifier Low / Median / High Price $55.10 / $69.73 / $119.98	Professional		$55.10	$69.73	$119.98
United Facility/Professional Professional Modifier Low / Median / High Price $40.79 / $68.12 / $141.61	Professional		$40.79	$68.12	$141.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $26.91 / $77.61	Professional	26	$18.62	$26.91	$77.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.80 / $32.36 / $64.00	Professional	TC	$20.80	$32.36	$64.00