Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,786.17 / $5,522.62 / $21,126.00	Facility		$1,786.17	$5,522.62	$21,126.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,608.20 / $4,141.97 / $4,141.97	Facility	54	$1,608.20	$4,141.97	$4,141.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,238.91 / $1,528.72 / $2,492.33	Professional		$1,238.91	$1,528.72	$2,492.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,261.33 / $1,450.53 / $2,991.87	Professional		$1,261.33	$1,450.53	$2,991.87
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 $1,257.63 / $2,156.60 / $3,336.93	Professional		$1,257.63	$2,156.60	$3,336.93
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $176.06 / $301.92 / $467.17	Professional	AS	$176.06	$301.92	$467.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,453.24 / $1,453.24 / $1,453.24	Facility		$1,453.24	$1,453.24	$1,453.24
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,006.58 / $1,006.58 / $1,006.58	Facility	54	$1,006.58	$1,006.58	$1,006.58
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $143.80 / $143.80 / $143.80	Facility	AS	$143.80	$143.80	$143.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,680.04 / $2,516.17 / $3,853.92	Professional		$1,680.04	$2,516.17	$3,853.92
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $1,439.73 / $2,362.02 / $4,443.72	Professional		$1,439.73	$2,362.02	$4,443.72
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 $1,584.53 / $2,094.55 / $3,669.96	Professional		$1,584.53	$2,094.55	$3,669.96
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $1,103.04 / $1,323.65 / $2,018.40	Professional		$1,103.04	$1,323.65	$2,018.40