Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $3,487.85 / $21,794.31	Facility		$100.00	$3,487.85	$21,794.31
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,743.93 / $1,743.93 / $1,743.93	Facility	52	$1,743.93	$1,743.93	$1,743.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $765.41 / $887.31 / $1,912.20	Professional		$765.41	$887.31	$1,912.20
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 $1,173.58 / $1,854.83 / $2,699.93	Professional		$1,173.58	$1,854.83	$2,699.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,320.39 / $2,190.32 / $3,128.04	Professional		$1,320.39	$2,190.32	$3,128.04
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $1,138.30 / $2,258.16 / $3,749.67	Professional		$1,138.30	$2,258.16	$3,749.67
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 $1,138.30 / $1,751.47 / $3,896.54	Professional		$1,138.30	$1,751.47	$3,896.54
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $789.18 / $947.02 / $1,494.71	Professional		$789.18	$947.02	$1,494.71