Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.62 / $388.40 / $496.00	Facility	26	$116.62	$388.40	$496.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.36 / $384.87 / $1,117.00	Professional		$252.36	$384.87	$1,117.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.10 / $116.62 / $366.33	Professional	26	$84.10	$116.62	$366.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.09 / $257.39 / $440.36	Professional	TC	$165.09	$257.39	$440.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.06 / $576.73 / $777.46	Professional		$245.06	$576.73	$777.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $82.73 / $200.76 / $280.23	Professional	26	$82.73	$200.76	$280.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $382.05 / $497.23	Professional	TC	$162.34	$382.05	$497.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.58 / $410.50 / $746.92	Professional		$286.58	$410.50	$746.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.71 / $135.29 / $265.08	Professional	26	$96.71	$135.29	$265.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.07 / $251.71 / $486.66	Professional	TC	$186.07	$251.71	$486.66
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $267.52 / $380.92 / $452.36	Professional		$267.52	$380.92	$452.36
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $91.78 / $131.21 / $151.27	Professional	26	$91.78	$131.21	$151.27
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $175.75 / $246.89 / $301.08	Professional	TC	$175.75	$246.89	$301.08
Health New England Facility/Professional Professional Modifier Low / Median / High Price $127.34 / $181.74 / $907.50	Professional		$127.34	$181.74	$907.50
United Facility/Professional Professional Modifier Low / Median / High Price $239.27 / $361.70 / $792.82	Professional		$239.27	$361.70	$792.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.34 / $127.24 / $285.23	Professional	26	$87.34	$127.24	$285.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.93 / $228.27 / $523.72	Professional	TC	$151.93	$228.27	$523.72