Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $438.63 / $548.00 / $3,206.00	Facility		$438.63	$548.00	$3,206.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.48 / $228.29 / $322.55	Facility	26	$71.48	$228.29	$322.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.57 / $244.68 / $880.00	Professional		$151.57	$244.68	$880.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.76 / $61.14 / $116.38	Professional	26	$39.76	$61.14	$116.38
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $170.28 / $170.28 / $170.28	Professional	52	$170.28	$170.28	$170.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.81 / $163.53 / $250.59	Professional	TC	$105.81	$163.53	$250.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.03 / $223.33 / $358.32	Professional		$130.03	$223.33	$358.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.20 / $61.45 / $112.11	Professional	26	$37.20	$61.45	$112.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $88.73 / $161.87 / $246.20	Professional	TC	$88.73	$161.87	$246.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $283.67 / $539.29 / $2,000.00	Facility		$283.67	$539.29	$2,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.42 / $288.74 / $495.42	Professional		$190.42	$288.74	$495.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.78 / $77.18 / $126.76	Professional	26	$47.78	$77.18	$126.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.63 / $211.57 / $371.55	Professional	TC	$138.63	$211.57	$371.55
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $149.99 / $214.41 / $1,687.57	Professional		$149.99	$214.41	$1,687.57
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $43.62 / $62.35 / $79.18	Professional	26	$43.62	$62.35	$79.18
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $106.37 / $152.07 / $1,618.09	Professional	TC	$106.37	$152.07	$1,618.09
Health New England Facility/Professional Facility Modifier Low / Median / High Price $697.31 / $697.31 / $700.30	Facility		$697.31	$697.31	$700.30
Health New England Facility/Professional Professional Modifier Low / Median / High Price $81.77 / $109.86 / $246.04	Professional		$81.77	$109.86	$246.04
United Facility/Professional Professional Modifier Low / Median / High Price $168.90 / $292.20 / $458.11	Professional		$168.90	$292.20	$458.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.36 / $74.81 / $120.17	Professional	26	$42.36	$74.81	$120.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.31 / $213.22 / $350.03	Professional	TC	$126.31	$213.22	$350.03