Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.81 / $562.90 / $828.69	Facility		$178.81	$562.90	$828.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.10 / $86.85 / $127.94	Facility	26	$31.10	$86.85	$127.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.38 / $214.52 / $588.66	Professional		$136.38	$214.52	$588.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.03 / $31.10 / $87.66	Professional	26	$21.03	$31.10	$87.66
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $62.47 / $99.00 / $219.37	Professional	52	$62.47	$99.00	$219.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.47 / $166.90 / $296.30	Professional	TC	$117.47	$166.90	$296.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $582.69 / $747.77 / $964.24	Facility		$582.69	$747.77	$964.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.16 / $223.17 / $308.35	Professional		$118.16	$223.17	$308.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.88 / $33.28 / $43.45	Professional	26	$19.88	$33.28	$43.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.39 / $192.55 / $266.05	Professional	TC	$99.39	$192.55	$266.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $156.56 / $444.93 / $917.20	Facility		$156.56	$444.93	$917.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.05 / $241.93 / $415.15	Professional		$154.05	$241.93	$415.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.88 / $34.77 / $65.08	Professional	26	$24.88	$34.77	$65.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $118.46 / $211.10 / $354.55	Professional	TC	$118.46	$211.10	$354.55
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $152.58 / $218.57 / $271.50	Professional		$152.58	$218.57	$271.50
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $24.12 / $30.25 / $40.90	Professional	26	$24.12	$30.25	$40.90
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $128.47 / $190.85 / $222.75	Professional	TC	$128.47	$190.85	$222.75
Health New England Facility/Professional Facility Modifier Low / Median / High Price $721.80 / $721.80 / $721.80	Facility		$721.80	$721.80	$721.80
Health New England Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $43.01 / $251.90	Professional		$33.54	$43.01	$251.90
United Facility/Professional Professional Modifier Low / Median / High Price $133.94 / $219.15 / $385.30	Professional		$133.94	$219.15	$385.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.52 / $34.76 / $64.73	Professional	26	$21.52	$34.76	$64.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.24 / $181.12 / $333.76	Professional	TC	$112.24	$181.12	$333.76