Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $3,162.28 / $5,128.61	Facility		$630.96	$3,162.28	$5,128.61
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Facility	52	$1,949.84	$1,949.84	$1,949.84
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $112.20 / $229.09 / $3,715.35	Facility	53	$112.20	$229.09	$3,715.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $363.08 / $933.25	Professional		$181.97	$363.08	$933.25
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $67.61 / $144.54 / $275.42	Professional	53	$67.61	$144.54	$275.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility		$1,584.89	$1,584.89	$1,584.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $295.12 / $537.03	Professional		$165.96	$295.12	$537.03
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $83.18 / $141.25 / $229.09	Professional	53	$83.18	$141.25	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $616.60	Facility		$309.03	$309.03	$616.60
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $371.54 / $371.54 / $371.54	Facility	22	$371.54	$371.54	$371.54
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	52	$251.19	$251.19	$251.19
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	53	$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $398.11 / $758.58	Professional		$213.80	$398.11	$758.58
Community Health Options Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Facility		$2,691.53	$2,691.53	$2,691.53
Community Health Options Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $275.42 / $371.54	Professional		$213.80	$275.42	$371.54
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $467.74 / $1,000.00	Professional		$204.17	$467.74	$1,000.00
Harvard Pilgrim Facility/Professional Professional Modifier 53 Low / Median / High Price $131.83 / $131.83 / $257.04	Professional	53	$131.83	$131.83	$257.04
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $2,884.03 / $5,248.07	Facility		$398.11	$2,884.03	$5,248.07
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Facility	52	$1,949.84	$1,949.84	$1,949.84
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $112.20 / $229.09 / $263.03	Facility	53	$112.20	$229.09	$263.03
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $398.11 / $831.76	Professional		$204.17	$398.11	$831.76
Martin's Point Facility/Professional Professional Modifier 53 Low / Median / High Price $83.18 / $177.83 / $389.05	Professional	53	$83.18	$177.83	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $371.54 / $724.44	Professional		$204.17	$371.54	$724.44
United Facility/Professional Professional Modifier 53 Low / Median / High Price $131.83 / $218.78 / $257.04	Professional	53	$131.83	$218.78	$257.04