Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.39 / $338.26 / $472.83	Facility	26	$85.39	$338.26	$472.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $374.64 / $486.23 / $801.50	Professional		$374.64	$486.23	$801.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.40 / $65.44 / $107.18	Professional	26	$53.40	$65.44	$107.18
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $186.47 / $222.69 / $353.05	Professional	52	$186.47	$222.69	$353.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $316.76 / $427.46 / $694.30	Professional	TC	$316.76	$427.46	$694.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $371.55 / $545.91 / $1,109.04	Professional		$371.55	$545.91	$1,109.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $75.12 / $137.87	Professional	26	$51.32	$75.12	$137.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $321.01 / $471.65 / $971.17	Professional	TC	$321.01	$471.65	$971.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $510.82 / $709.08 / $1,253.74	Professional		$510.82	$709.08	$1,253.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.84 / $100.68 / $180.20	Professional	26	$71.84	$100.68	$180.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $431.37 / $608.57 / $1,066.42	Professional	TC	$431.37	$608.57	$1,066.42
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $486.96 / $624.84 / $1,151.00	Professional		$486.96	$624.84	$1,151.00
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $65.58 / $76.23 / $119.22	Professional	26	$65.58	$76.23	$119.22
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $421.38 / $526.85 / $710.26	Professional	TC	$421.38	$526.85	$710.26
United Facility/Professional Professional Modifier Low / Median / High Price $413.92 / $703.77 / $1,212.18	Professional		$413.92	$703.77	$1,212.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.75 / $98.32 / $176.68	Professional	26	$59.75	$98.32	$176.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $351.51 / $559.67 / $1,045.20	Professional	TC	$351.51	$559.67	$1,045.20