Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $925.48 / $3,711.00 / $7,629.00	Facility		$925.48	$3,711.00	$7,629.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,294.81 / $3,294.81 / $3,294.81	Facility	22	$3,294.81	$3,294.81	$3,294.81
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $138.91 / $233.40 / $338.32	Facility	52	$138.91	$233.40	$338.32
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $55.57 / $140.07 / $338.02	Facility	53	$55.57	$140.07	$338.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.03 / $359.26 / $818.91	Professional		$201.03	$359.26	$818.91
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $55.57 / $124.80 / $276.31	Professional	53	$55.57	$124.80	$276.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,402.00 / $3,456.07 / $6,450.00	Facility		$2,402.00	$3,456.07	$6,450.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.93 / $522.27 / $728.99	Professional		$188.93	$522.27	$728.99
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $80.44 / $192.31 / $280.91	Professional	53	$80.44	$192.31	$280.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,222.49 / $1,265.79	Facility		$1,020.00	$1,222.49	$1,265.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.68 / $431.66 / $846.16	Professional		$253.68	$431.66	$846.16
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $143.54 / $210.90 / $357.87	Professional	53	$143.54	$210.90	$357.87
ConnectiCare Facility/Professional Facility Modifier Low / Median / High Price $735.56 / $886.65 / $1,215.58	Facility		$735.56	$886.65	$1,215.58
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $331.50 / $563.49 / $822.87	Professional		$331.50	$563.49	$822.87
ConnectiCare Facility/Professional Professional Modifier 53 Low / Median / High Price $204.48 / $282.07 / $479.06	Professional	53	$204.48	$282.07	$479.06
Health New England Facility/Professional Facility Modifier Low / Median / High Price $1,988.76 / $2,122.69 / $5,208.32	Facility		$1,988.76	$2,122.69	$5,208.32
Health New England Facility/Professional Professional Modifier Low / Median / High Price $211.71 / $389.93 / $547.51	Professional		$211.71	$389.93	$547.51
United Facility/Professional Facility Modifier Low / Median / High Price $911.00 / $4,097.00 / $7,560.00	Facility		$911.00	$4,097.00	$7,560.00
United Facility/Professional Professional Modifier Low / Median / High Price $296.38 / $533.91 / $1,223.32	Professional		$296.38	$533.91	$1,223.32
United Facility/Professional Professional Modifier 53 Low / Median / High Price $116.17 / $267.31 / $422.53	Professional	53	$116.17	$267.31	$422.53