Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.52 / $49.69 / $74.97	Facility	26	$17.52	$49.69	$74.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $138.87 / $431.00	Professional		$86.00	$138.87	$431.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $17.51 / $49.49	Professional	26	$11.48	$17.51	$49.49
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $40.14 / $63.79 / $347.25	Professional	52	$40.14	$63.79	$347.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.58 / $110.05 / $196.29	Professional	TC	$77.58	$110.05	$196.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.68 / $144.06 / $199.05	Professional		$74.68	$144.06	$199.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $18.17 / $23.40	Professional	26	$11.04	$18.17	$23.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.44 / $125.25 / $176.28	Professional	TC	$64.44	$125.25	$176.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.82 / $157.06 / $269.39	Professional		$89.82	$157.06	$269.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.94 / $19.89 / $36.43	Professional	26	$13.94	$19.89	$36.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.01 / $136.87 / $232.65	Professional	TC	$76.01	$136.87	$232.65
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $96.17 / $141.62 / $169.50	Professional		$96.17	$141.62	$169.50
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $14.48 / $19.17 / $57.62	Professional	26	$14.48	$19.17	$57.62
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $82.75 / $122.96 / $142.50	Professional	TC	$82.75	$122.96	$142.50
Health New England Facility/Professional Professional Modifier Low / Median / High Price $18.34 / $35.49 / $157.28	Professional		$18.34	$35.49	$157.28
United Facility/Professional Professional Modifier Low / Median / High Price $82.09 / $133.28 / $255.49	Professional		$82.09	$133.28	$255.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.31 / $19.14 / $39.36	Professional	26	$12.31	$19.14	$39.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.63 / $130.38 / $231.42	Professional	TC	$73.63	$130.38	$231.42