Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $204.17 / $251.19	Facility	26	$104.71	$204.17	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $91.20 / $251.19	Professional		$63.10	$91.20	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $52.48 / $141.25	Professional	26	$37.15	$52.48	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $38.90 / $72.44	Professional	TC	$19.95	$38.90	$72.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $112.20 / $186.21	Professional		$63.10	$112.20	$186.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $74.13 / $102.33	Professional	26	$30.90	$74.13	$102.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $41.69 / $85.11	Professional	TC	$26.30	$41.69	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $112.20 / $269.15	Professional		$77.62	$112.20	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $67.61 / $138.04	Professional	26	$46.77	$67.61	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $47.86 / $125.89	Professional	TC	$28.18	$47.86	$125.89
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $120.23 / $158.49	Professional		$95.50	$120.23	$158.49
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $66.07 / $79.43	Professional	26	$54.95	$66.07	$79.43
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $60.26 / $77.62	Professional	TC	$34.67	$60.26	$77.62
Health New England Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $144.54	Professional		$83.18	$83.18	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $204.17	Professional		$69.18	$102.33	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $60.26 / $107.15	Professional	26	$41.69	$60.26	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $42.66 / $97.72	Professional	TC	$28.18	$42.66	$97.72