Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.18 / $117.12 / $719.80	Facility	26	$35.18	$117.12	$719.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.65 / $178.49 / $623.00	Professional		$108.65	$178.49	$623.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.85 / $35.18 / $138.00	Professional	26	$21.85	$35.18	$138.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.79 / $126.39 / $217.54	Professional	TC	$82.79	$126.39	$217.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.24 / $246.39 / $326.02	Professional		$102.24	$246.39	$326.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.96 / $59.37 / $82.87	Professional	26	$24.96	$59.37	$82.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.94 / $187.66 / $243.15	Professional	TC	$76.94	$187.66	$243.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.40 / $169.01 / $317.99	Professional		$122.40	$169.01	$317.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.18 / $39.09 / $79.08	Professional	26	$29.18	$39.09	$79.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.05 / $127.75 / $238.02	Professional	TC	$94.05	$127.75	$238.02
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $114.02 / $162.99 / $193.67	Professional		$114.02	$162.99	$193.67
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $27.71 / $39.50 / $45.81	Professional	26	$27.71	$39.50	$45.81
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $86.30 / $123.36 / $147.86	Professional	TC	$86.30	$123.36	$147.86
Health New England Facility/Professional Professional Modifier Low / Median / High Price $38.25 / $50.38 / $76.44	Professional		$38.25	$50.38	$76.44
United Facility/Professional Professional Modifier Low / Median / High Price $100.69 / $150.29 / $341.64	Professional		$100.69	$150.29	$341.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.93 / $37.40 / $83.96	Professional	26	$24.93	$37.40	$83.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.34 / $111.69 / $256.91	Professional	TC	$74.34	$111.69	$256.91