Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.13 / $598.53 / $939.11	Facility		$127.13	$598.53	$939.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.44 / $95.06 / $137.97	Facility	26	$33.44	$95.06	$137.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.97 / $180.34 / $756.00	Professional		$108.97	$180.34	$756.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $33.44 / $108.13	Professional	26	$18.44	$33.44	$108.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $206.46 / $206.46 / $206.46	Professional	50	$206.46	$206.46	$206.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.26 / $155.22 / $279.19	Professional	TC	$102.26	$155.22	$279.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $642.85 / $824.98 / $1,063.80	Facility		$642.85	$824.98	$1,063.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.11 / $263.08 / $396.16	Professional		$117.11	$263.08	$396.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.85 / $31.24 / $40.99	Professional	26	$19.85	$31.24	$40.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.27 / $157.75 / $215.02	Professional	TC	$97.27	$157.75	$215.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.10 / $484.61 / $884.21	Facility		$174.10	$484.61	$884.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.61 / $259.79 / $452.54	Professional		$163.61	$259.79	$452.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.61 / $32.04 / $69.54	Professional	26	$24.61	$32.04	$69.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.69 / $227.63 / $399.99	Professional	TC	$134.69	$227.63	$399.99
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $155.18 / $229.71 / $300.00	Professional		$155.18	$229.71	$300.00
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $23.74 / $31.16 / $41.25	Professional	26	$23.74	$31.16	$41.25
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $129.65 / $192.59 / $258.75	Professional	TC	$129.65	$192.59	$258.75
Health New England Facility/Professional Facility Modifier Low / Median / High Price $537.91 / $537.91 / $748.30	Facility		$537.91	$537.91	$748.30
Health New England Facility/Professional Professional Modifier Low / Median / High Price $35.63 / $46.63 / $278.93	Professional		$35.63	$46.63	$278.93
United Facility/Professional Professional Modifier Low / Median / High Price $151.88 / $245.09 / $450.90	Professional		$151.88	$245.09	$450.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.41 / $36.63 / $64.83	Professional	26	$22.41	$36.63	$64.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.12 / $209.96 / $380.97	Professional	TC	$128.12	$209.96	$380.97