Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.06 / $113.70 / $258.04	Facility	26	$64.06	$113.70	$258.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.50 / $128.52 / $710.22	Professional		$77.50	$128.52	$710.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $58.60 / $285.60	Professional	26	$40.29	$58.60	$285.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $232.54 / $419.48 / $583.77	Professional	50	$232.54	$419.48	$583.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.92 / $52.02 / $106.35	Professional	TC	$39.92	$52.02	$106.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.05 / $124.35 / $176.16	Professional		$80.05	$124.35	$176.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.54 / $56.61 / $87.83	Professional	26	$39.54	$56.61	$87.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.80 / $64.23 / $86.41	Professional	TC	$41.80	$64.23	$86.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.14 / $144.56 / $298.30	Professional		$117.14	$144.56	$298.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.99 / $69.41 / $133.08	Professional	26	$55.99	$69.41	$133.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.17 / $77.94 / $165.22	Professional	TC	$56.17	$77.94	$165.22
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $107.87 / $128.86 / $189.14	Professional		$107.87	$128.86	$189.14
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $50.68 / $59.24 / $91.21	Professional	26	$50.68	$59.24	$91.21
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $51.72 / $69.61 / $97.91	Professional	TC	$51.72	$69.61	$97.91
Health New England Facility/Professional Professional Modifier Low / Median / High Price $93.26 / $175.00 / $350.00	Professional		$93.26	$175.00	$350.00
United Facility/Professional Professional Modifier Low / Median / High Price $99.25 / $150.29 / $288.61	Professional		$99.25	$150.29	$288.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.78 / $69.95 / $133.57	Professional	26	$43.78	$69.95	$133.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.28 / $84.60 / $159.84	Professional	TC	$51.28	$84.60	$159.84