Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $365.94 / $4,090.00 / $7,629.00	Facility		$365.94	$4,090.00	$7,629.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $206.50 / $222.25 / $293.35	Facility	54	$206.50	$222.25	$293.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.97 / $206.43 / $503.75	Professional		$163.97	$206.43	$503.75
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $127.19 / $159.08 / $372.62	Professional	54	$127.19	$159.08	$372.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,410.00 / $6,763.00 / $11,797.00	Facility		$5,410.00	$6,763.00	$11,797.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.03 / $345.98 / $470.46	Professional		$179.03	$345.98	$470.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $353.26 / $353.26	Facility		$50.00	$353.26	$353.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.52 / $336.13 / $502.45	Professional		$222.52	$336.13	$502.45
ConnectiCare Facility/Professional Facility Modifier Low / Median / High Price $1,340.80 / $1,643.00 / $1,677.00	Facility		$1,340.80	$1,643.00	$1,677.00
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $184.77 / $274.75 / $344.09	Professional		$184.77	$274.75	$344.09
Health New England Facility/Professional Facility Modifier Low / Median / High Price $101.45 / $101.45 / $101.45	Facility		$101.45	$101.45	$101.45
Health New England Facility/Professional Professional Modifier Low / Median / High Price $191.20 / $233.22 / $639.76	Professional		$191.20	$233.22	$639.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.00 / $3,075.00 / $6,664.00	Facility		$1,380.00	$3,075.00	$6,664.00
United Facility/Professional Professional Modifier Low / Median / High Price $177.43 / $354.86 / $603.00	Professional		$177.43	$354.86	$603.00