Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $280.24 / $849.01 / $1,540.62	Facility		$280.24	$849.01	$1,540.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.98 / $135.12 / $197.79	Facility	26	$47.98	$135.12	$197.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $234.94 / $690.61 / $943.27	Facility	TC	$234.94	$690.61	$943.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.68 / $288.36 / $979.00	Professional		$183.68	$288.36	$979.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.89 / $46.46 / $167.99	Professional	26	$31.89	$46.46	$167.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.80 / $234.94 / $507.80	Professional	TC	$151.80	$234.94	$507.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $813.00 / $1,043.33 / $1,345.37	Facility		$813.00	$1,043.33	$1,345.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.29 / $299.37 / $365.03	Professional		$169.29	$299.37	$365.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.89 / $50.21 / $66.18	Professional	26	$28.89	$50.21	$66.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $140.99 / $245.08 / $299.32	Professional	TC	$140.99	$245.08	$299.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $217.49 / $641.08 / $1,228.02	Facility		$217.49	$641.08	$1,228.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.61 / $344.58 / $587.17	Professional		$228.61	$344.58	$587.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.50 / $50.69 / $98.33	Professional	26	$37.50	$50.69	$98.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.35 / $293.83 / $517.39	Professional	TC	$174.35	$293.83	$517.39
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $239.33 / $343.61 / $776.66	Professional		$239.33	$343.61	$776.66
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $40.42 / $52.28 / $131.44	Professional	26	$40.42	$52.28	$131.44
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $180.02 / $267.12 / $380.32	Professional	TC	$180.02	$267.12	$380.32
Health New England Facility/Professional Facility Modifier Low / Median / High Price $609.83 / $814.62 / $1,098.03	Facility		$609.83	$814.62	$1,098.03
Health New England Facility/Professional Professional Modifier Low / Median / High Price $49.50 / $74.06 / $353.89	Professional		$49.50	$74.06	$353.89
United Facility/Professional Professional Modifier Low / Median / High Price $197.24 / $305.45 / $585.57	Professional		$197.24	$305.45	$585.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.34 / $52.06 / $103.24	Professional	26	$34.34	$52.06	$103.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.47 / $263.32 / $486.17	Professional	TC	$163.47	$263.32	$486.17