Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $9,859.00	Facility		$100.00	$100.00	$9,859.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.60 / $13.60 / $13.60	Professional		$13.60	$13.60	$13.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,769.10 / $5,299.00 / $8,600.00	Facility		$4,769.10	$5,299.00	$8,600.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.52 / $92.52 / $92.52	Professional		$92.52	$92.52	$92.52
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $149.97 / $297.51 / $494.02	Professional		$149.97	$297.51	$494.02
United Facility/Professional Facility Modifier Low / Median / High Price $11,155.00 / $11,155.00 / $11,155.00	Facility		$11,155.00	$11,155.00	$11,155.00
United Facility/Professional Professional Modifier Low / Median / High Price $39.60 / $96.83 / $195.26	Professional		$39.60	$96.83	$195.26
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