Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $625.41 / $1,556.60 / $2,937.30	Facility		$625.41	$1,556.60	$2,937.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.29 / $313.98 / $415.90	Facility	26	$87.29	$313.98	$415.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.19 / $332.67 / $927.00	Professional		$215.19	$332.67	$927.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.92 / $81.98 / $277.48	Professional	26	$53.92	$81.98	$277.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.47 / $237.50 / $665.00	Professional	TC	$147.47	$237.50	$665.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $761.29 / $1,063.46 / $1,501.00	Facility		$761.29	$1,063.46	$1,501.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.01 / $489.04 / $682.60	Professional		$203.01	$489.04	$682.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.03 / $162.51 / $207.18	Professional	26	$69.03	$162.51	$207.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $136.71 / $343.66 / $475.41	Professional	TC	$136.71	$343.66	$475.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $514.16 / $873.65 / $1,405.35	Facility		$514.16	$873.65	$1,405.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.19 / $393.17 / $664.44	Professional		$245.19	$393.17	$664.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.15 / $101.66 / $222.91	Professional	26	$79.15	$101.66	$222.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.77 / $279.62 / $439.08	Professional	TC	$164.77	$279.62	$439.08
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $249.65 / $346.93 / $556.50	Professional		$249.65	$346.93	$556.50
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $84.65 / $98.86 / $149.25	Professional	26	$84.65	$98.86	$149.25
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $149.33 / $213.47 / $280.77	Professional	TC	$149.33	$213.47	$280.77
Health New England Facility/Professional Facility Modifier Low / Median / High Price $1,303.25 / $1,627.92 / $2,572.16	Facility		$1,303.25	$1,627.92	$2,572.16
Health New England Facility/Professional Professional Modifier Low / Median / High Price $108.53 / $208.69 / $488.96	Professional		$108.53	$208.69	$488.96
United Facility/Professional Professional Modifier Low / Median / High Price $211.49 / $313.42 / $716.60	Professional		$211.49	$313.42	$716.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.94 / $106.61 / $245.20	Professional	26	$69.94	$106.61	$245.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $136.41 / $218.15 / $471.40	Professional	TC	$136.41	$218.15	$471.40