Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.35 / $324.22 / $415.90	Facility	26	$97.35	$324.22	$415.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.65 / $333.12 / $994.00	Professional		$212.65	$333.12	$994.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.81 / $104.17 / $374.97	Professional	26	$71.81	$104.17	$374.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.71 / $199.37 / $395.59	Professional	TC	$140.71	$199.37	$395.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.73 / $460.31 / $614.28	Professional		$179.73	$460.31	$614.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.37 / $162.51 / $215.50	Professional	26	$63.37	$162.51	$215.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $118.25 / $304.72 / $398.78	Professional	TC	$118.25	$304.72	$398.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.33 / $302.16 / $603.17	Professional		$193.33	$302.16	$603.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.73 / $110.01 / $221.27	Professional	26	$80.73	$110.01	$221.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.35 / $195.07 / $384.61	Professional	TC	$95.35	$195.07	$384.61
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $295.50 / $354.99	Professional		$144.00	$295.50	$354.99
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $76.59 / $109.51 / $126.20	Professional	26	$76.59	$109.51	$126.20
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $135.88 / $194.25 / $228.41	Professional	TC	$135.88	$194.25	$228.41
Health New England Facility/Professional Professional Modifier Low / Median / High Price $108.53 / $137.62 / $156.96	Professional		$108.53	$137.62	$156.96
United Facility/Professional Professional Modifier Low / Median / High Price $193.16 / $281.02 / $652.16	Professional		$193.16	$281.02	$652.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.67 / $103.52 / $237.21	Professional	26	$71.67	$103.52	$237.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.28 / $185.80 / $416.50	Professional	TC	$120.28	$185.80	$416.50