Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $91.20 / $102.33	Facility		$23.99	$91.20	$102.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.02 / $15.49 / $17.78	Facility	26	$3.02	$15.49	$17.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $33.88 / $117.49	Professional		$18.62	$33.88	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.00 / $3.09 / $16.60	Professional	26	$2.00	$3.09	$16.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $40.74 / $40.74 / $41.69	Professional	52	$40.74	$40.74	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $51.29	Professional	TC	$15.14	$21.88	$51.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $30.90 / $44.67	Professional		$20.42	$30.90	$44.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.69 / $4.17 / $7.24	Professional	26	$2.69	$4.17	$7.24
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $29.51 / $45.71 / $64.57	Professional	50	$29.51	$45.71	$64.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.30 / $37.15	Professional	TC	$17.78	$26.30	$37.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $107.15 / $257.04	Facility		$69.18	$107.15	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $48.98 / $83.18	Professional		$21.88	$48.98	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.95 / $7.41 / $18.62	Professional	26	$2.95	$7.41	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $41.69 / $64.57	Professional	TC	$18.62	$41.69	$64.57
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $37.15 / $48.98	Professional		$28.84	$37.15	$48.98
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $3.55 / $5.01 / $6.17	Professional	26	$3.55	$5.01	$6.17
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.11 / $42.66	Professional	TC	$25.12	$33.11	$42.66
Health New England Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $7.59 / $7.59	Professional		$7.59	$7.59	$7.59
United Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $28.84 / $52.48	Professional		$17.78	$28.84	$52.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.51 / $3.80 / $10.72	Professional	26	$2.51	$3.80	$10.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $23.44 / $43.65	Professional	TC	$15.14	$23.44	$43.65