Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $288.40 / $338.84	Facility	26	$144.54	$288.40	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $181.97 / $512.86	Professional		$147.91	$181.97	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $63.10 / $181.97	Professional	26	$52.48	$63.10	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $114.82 / $281.84	Professional	TC	$91.20	$114.82	$281.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $257.04 / $489.78	Professional		$141.25	$257.04	$489.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $77.62 / $117.49	Professional	26	$48.98	$77.62	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $162.18 / $380.19	Professional	TC	$93.33	$162.18	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $467.74 / $1,047.13	Professional		$302.00	$467.74	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $87.10 / $177.83	Professional	26	$54.95	$87.10	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $371.54 / $870.96	Professional	TC	$239.88	$371.54	$870.96
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $331.13 / $537.03	Professional		$199.53	$331.13	$537.03
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $89.13 / $114.82	Professional	26	$67.61	$89.13	$114.82
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $218.78 / $446.68	Professional	TC	$128.82	$218.78	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $407.38 / $851.14	Professional		$281.84	$407.38	$851.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $77.62 / $151.36	Professional	26	$52.48	$77.62	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $331.13 / $691.83	Professional	TC	$229.09	$331.13	$691.83