Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $120.23 / $724.44	Facility	26	$61.66	$120.23	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $177.83 / $537.03	Professional		$95.50	$177.83	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $35.48 / $109.65	Professional	26	$22.39	$35.48	$109.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $89.13 / $218.78	Professional	TC	$67.61	$89.13	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $229.09 / $323.59	Professional		$104.71	$229.09	$323.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $58.88 / $81.28	Professional	26	$24.55	$58.88	$81.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $169.82 / $245.47	Professional	TC	$79.43	$169.82	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $169.82 / $331.13	Professional		$117.49	$169.82	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $38.02 / $81.28	Professional	26	$26.92	$38.02	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $131.83 / $251.19	Professional	TC	$87.10	$131.83	$251.19
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $162.18 / $204.17	Professional		$120.23	$162.18	$204.17
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $39.81 / $48.98	Professional	26	$28.84	$39.81	$48.98
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $123.03 / $154.88	Professional	TC	$91.20	$123.03	$154.88
Health New England Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $50.12 / $60.26	Professional		$44.67	$50.12	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $138.04 / $288.40	Professional		$95.50	$138.04	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $33.88 / $74.13	Professional	26	$25.12	$33.88	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $104.71 / $218.78	Professional	TC	$70.79	$104.71	$218.78