Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $104.71 / $309.03	Professional		$85.11	$104.71	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $75.86 / $100.00	Professional	26	$63.10	$75.86	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $36.31	Professional	TC	$19.05	$28.84	$36.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $151.36 / $186.21	Professional		$89.13	$151.36	$186.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $117.49 / $141.25	Professional	26	$69.18	$117.49	$141.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $36.31 / $52.48	Professional	TC	$19.95	$36.31	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $134.90 / $251.19	Professional		$100.00	$134.90	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $109.65 / $186.21	Professional	26	$69.18	$109.65	$186.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.90 / $69.18	Professional	TC	$19.95	$30.90	$69.18
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $123.03 / $169.82	Professional		$100.00	$123.03	$169.82
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $87.10 / $120.23	Professional	26	$81.28	$87.10	$120.23
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $34.67 / $50.12	Professional	TC	$17.38	$34.67	$50.12
Health New England Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $398.11	Professional		$186.21	$186.21	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $218.78	Professional		$89.13	$123.03	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $93.33 / $165.96	Professional	26	$67.61	$93.33	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $31.62 / $66.07	Professional	TC	$20.42	$31.62	$66.07