Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,768.14 / $8,955.89 / $23,654.52	Facility		$1,768.14	$8,955.89	$23,654.52
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,610.27 / $3,868.98 / $3,868.98	Facility	54	$1,610.27	$3,868.98	$3,868.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,239.27 / $1,670.75 / $2,493.59	Professional		$1,239.27	$1,670.75	$2,493.59
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $262.99 / $393.24 / $393.24	Professional	AS	$262.99	$393.24	$393.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,159.77 / $1,313.48 / $2,995.74	Professional		$1,159.77	$1,313.48	$2,995.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28,613.70 / $31,793.00 / $50,515.00	Facility		$28,613.70	$31,793.00	$50,515.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,259.25 / $2,159.38 / $3,341.23	Professional		$1,259.25	$2,159.38	$3,341.23
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $176.29 / $302.31 / $455.47	Professional	AS	$176.29	$302.31	$455.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,455.37 / $1,455.37 / $1,455.37	Facility		$1,455.37	$1,455.37	$1,455.37
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,008.15 / $1,008.15 / $1,008.15	Facility	54	$1,008.15	$1,008.15	$1,008.15
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $900.13 / $900.13 / $900.13	Facility	62	$900.13	$900.13	$900.13
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $144.02 / $144.02 / $144.02	Facility	AS	$144.02	$144.02	$144.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,682.29 / $2,442.83 / $3,901.83	Professional		$1,682.29	$2,442.83	$3,901.83
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $1,441.58 / $2,365.06 / $4,449.43	Professional		$1,441.58	$2,365.06	$4,449.43
United Facility/Professional Facility Modifier Low / Median / High Price $12,629.00 / $12,629.00 / $12,629.00	Facility		$12,629.00	$12,629.00	$12,629.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,537.74 / $2,025.28 / $3,759.74	Professional		$1,537.74	$2,025.28	$3,759.74
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $1,067.04 / $1,280.45 / $2,020.97	Professional		$1,067.04	$1,280.45	$2,020.97