Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.13 / $562.86 / $939.11	Facility		$127.13	$562.86	$939.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.47 / $106.05 / $128.28	Facility	26	$30.47	$106.05	$128.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $141.77 / $337.82 / $589.36	Facility	TC	$141.77	$337.82	$589.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.62 / $172.24 / $670.00	Professional		$80.62	$172.24	$670.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.13 / $30.47 / $118.26	Professional	26	$21.13	$30.47	$118.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.53 / $141.77 / $321.52	Professional	TC	$95.53	$141.77	$321.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $494.16 / $634.16 / $817.75	Facility		$494.16	$634.16	$817.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.70 / $190.80 / $232.65	Professional		$107.70	$190.80	$232.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.19 / $32.94 / $43.45	Professional	26	$18.19	$32.94	$43.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.64 / $155.16 / $190.31	Professional	TC	$89.64	$155.16	$190.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $132.35 / $392.52 / $828.15	Facility		$132.35	$392.52	$828.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.71 / $220.82 / $378.71	Professional		$143.71	$220.82	$378.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.58 / $32.99 / $64.53	Professional	26	$24.58	$32.99	$64.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.14 / $190.40 / $326.85	Professional	TC	$110.14	$190.40	$326.85
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $181.39 / $236.30 / $405.62	Professional		$181.39	$236.30	$405.62
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $26.10 / $33.76 / $72.27	Professional	26	$26.10	$33.76	$72.27
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $115.03 / $170.70 / $220.50	Professional	TC	$115.03	$170.70	$220.50
Health New England Facility/Professional Facility Modifier Low / Median / High Price $271.04 / $459.47 / $710.50	Facility		$271.04	$459.47	$710.50
Health New England Facility/Professional Professional Modifier Low / Median / High Price $32.49 / $59.59 / $261.52	Professional		$32.49	$59.59	$261.52
United Facility/Professional Professional Modifier Low / Median / High Price $123.11 / $201.43 / $393.68	Professional		$123.11	$201.43	$393.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.53 / $33.34 / $65.88	Professional	26	$21.53	$33.34	$65.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $101.41 / $166.21 / $316.73	Professional	TC	$101.41	$166.21	$316.73