Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $134.90 / $158.49	Facility	26	$38.90	$134.90	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $66.07 / $151.36	Professional		$56.23	$66.07	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $33.11 / $89.13	Professional	26	$25.12	$33.11	$89.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.88 / $72.44	Professional	TC	$28.84	$33.88	$72.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $93.33 / $131.83	Professional		$56.23	$93.33	$131.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $42.66 / $57.54	Professional	26	$26.30	$42.66	$57.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $50.12 / $69.18	Professional	TC	$28.84	$50.12	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $186.21	Professional		$64.57	$89.13	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $39.81 / $77.62	Professional	26	$30.20	$39.81	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $50.12 / $112.20	Professional	TC	$35.48	$50.12	$112.20
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $144.54	Professional		$87.10	$117.49	$144.54
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $44.67 / $56.23	Professional	26	$33.88	$44.67	$56.23
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $64.57 / $85.11	Professional	TC	$50.12	$64.57	$85.11
Health New England Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $50.12 / $56.23	Professional		$25.12	$50.12	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $77.62 / $169.82	Professional		$54.95	$77.62	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $35.48 / $67.61	Professional	26	$25.12	$35.48	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $39.81 / $87.10	Professional	TC	$28.18	$39.81	$87.10