Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $430.08 / $945.02 / $2,688.00	Facility		$430.08	$945.02	$2,688.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.40 / $134.40 / $155.52	Professional		$134.40	$134.40	$155.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $315.83 / $350.98 / $748.80	Facility		$315.83	$350.98	$748.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.80 / $249.60 / $249.60	Professional		$76.80	$249.60	$249.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $693.39 / $1,404.12 / $1,684.55	Facility		$693.39	$1,404.12	$1,684.55
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $400.17 / $682.44 / $1,264.93	Professional		$400.17	$682.44	$1,264.93
United Facility/Professional Professional Modifier Low / Median / High Price $80.64 / $115.20 / $230.40	Professional		$80.64	$115.20	$230.40
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $2,500.00 / $2,750.00 / $3,500.00	Professional		$2,500.00	$2,750.00	$3,500.00