Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.62 / $197.71 / $453.21	Facility	26	$111.62	$197.71	$453.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.24 / $174.88 / $486.00	Professional		$126.24	$174.88	$486.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.06 / $90.03 / $246.16	Professional	26	$70.06	$90.03	$246.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.63 / $68.64 / $128.59	Professional	TC	$52.63	$68.64	$128.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.42 / $175.44 / $259.69	Professional		$119.42	$175.44	$259.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.87 / $99.56 / $145.41	Professional	26	$66.87	$99.56	$145.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.65 / $75.89 / $116.00	Professional	TC	$51.65	$75.89	$116.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $171.33 / $221.52 / $425.25	Professional		$171.33	$221.52	$425.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.69 / $122.46 / $232.05	Professional	26	$97.69	$122.46	$232.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.16 / $101.20 / $193.20	Professional	TC	$76.16	$101.20	$193.20
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $153.37 / $181.69 / $268.91	Professional		$153.37	$181.69	$268.91
ConnectiCare Facility/Professional Professional Modifier 26 Low / Median / High Price $88.39 / $103.27 / $159.15	Professional	26	$88.39	$103.27	$159.15
ConnectiCare Facility/Professional Professional Modifier TC Low / Median / High Price $64.98 / $80.12 / $109.76	Professional	TC	$64.98	$80.12	$109.76
Health New England Facility/Professional Professional Modifier Low / Median / High Price $124.65 / $226.90 / $292.23	Professional		$124.65	$226.90	$292.23
United Facility/Professional Professional Modifier Low / Median / High Price $144.81 / $225.18 / $417.75	Professional		$144.81	$225.18	$417.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.94 / $122.88 / $247.17	Professional	26	$82.94	$122.88	$247.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.68 / $107.65 / $188.43	Professional	TC	$65.68	$107.65	$188.43