Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.95 / $96.51 / $142.31	Facility	26	$33.95	$96.51	$142.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.42 / $175.06 / $485.47	Professional		$91.42	$175.06	$485.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $31.05 / $88.08	Professional	26	$14.49	$31.05	$88.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.53 / $150.47 / $243.06	Professional	TC	$95.53	$150.47	$243.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.92 / $179.84 / $233.68	Professional		$111.92	$179.84	$233.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $26.81 / $39.17	Professional	26	$19.89	$26.81	$39.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.77 / $153.41 / $197.50	Professional	TC	$91.77	$153.41	$197.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.29 / $229.00 / $388.18	Professional		$150.29	$229.00	$388.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $27.76 / $70.59	Professional	26	$20.23	$27.76	$70.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $116.04 / $198.12 / $334.60	Professional	TC	$116.04	$198.12	$334.60
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $143.31 / $211.89 / $252.00	Professional		$143.31	$211.89	$252.00
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $18.50 / $28.65 / $37.70	Professional	26	$18.50	$28.65	$37.70
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $117.39 / $174.20 / $219.00	Professional	TC	$117.39	$174.20	$219.00
Health New England Facility/Professional Professional Modifier Low / Median / High Price $28.88 / $35.78 / $180.82	Professional		$28.88	$35.78	$180.82
United Facility/Professional Professional Modifier Low / Median / High Price $124.18 / $199.62 / $370.86	Professional		$124.18	$199.62	$370.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.26 / $37.03 / $69.39	Professional	26	$21.26	$37.03	$69.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.11 / $171.21 / $315.51	Professional	TC	$106.11	$171.21	$315.51