Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.59 / $141.86 / $322.97	Facility	26	$79.59	$141.86	$322.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.02 / $378.86 / $1,143.00	Professional		$286.02	$378.86	$1,143.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.40 / $67.87 / $228.52	Professional	26	$50.40	$67.87	$228.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $234.69 / $310.39 / $626.12	Professional	TC	$234.69	$310.39	$626.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $322.37 / $487.47 / $685.09	Professional		$322.37	$487.47	$685.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.80 / $71.69 / $104.72	Professional	26	$48.80	$71.69	$104.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $272.70 / $413.55 / $574.37	Professional	TC	$272.70	$413.55	$574.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.18 / $500.97 / $1,161.53	Professional		$234.18	$500.97	$1,161.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.81 / $89.29 / $165.36	Professional	26	$69.81	$89.29	$165.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.76 / $424.60 / $1,000.26	Professional	TC	$162.76	$424.60	$1,000.26
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $372.25 / $546.76 / $776.69	Professional		$372.25	$546.76	$776.69
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $63.25 / $73.98 / $113.84	Professional	26	$63.25	$73.98	$113.84
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $307.33 / $472.79 / $662.85	Professional	TC	$307.33	$472.79	$662.85
Health New England Facility/Professional Professional Modifier Low / Median / High Price $87.51 / $115.56 / $118.53	Professional		$87.51	$115.56	$118.53
United Facility/Professional Professional Modifier Low / Median / High Price $268.56 / $541.22 / $1,150.02	Professional		$268.56	$541.22	$1,150.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.19 / $87.21 / $167.19	Professional	26	$59.19	$87.21	$167.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $266.08 / $484.81 / $990.34	Professional	TC	$266.08	$484.81	$990.34