Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $2,187.76 / $4,265.80	Facility		$288.40	$2,187.76	$4,265.80
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $66.07 / $151.36 / $407.38	Facility	53	$66.07	$151.36	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $371.54 / $831.76	Professional		$186.21	$371.54	$831.76
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $74.13 / $154.88 / $281.84	Professional	53	$74.13	$154.88	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $1,096.48	Professional		$162.18	$218.78	$1,096.48
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $47.86 / $85.11 / $87.10	Professional	53	$47.86	$85.11	$87.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,412.54 / $2,630.27	Facility		$1,288.25	$1,412.54	$2,630.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $478.63 / $724.44	Professional		$165.96	$478.63	$724.44
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $83.18 / $199.53 / $281.84	Professional	53	$83.18	$199.53	$281.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility		$1,819.70	$1,819.70	$1,819.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $436.52 / $870.96	Professional		$229.09	$436.52	$870.96
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $204.17 / $204.17 / $204.17	Professional	53	$204.17	$204.17	$204.17
Harvard Pilgrim Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $3,890.45 / $8,709.64	Facility		$933.25	$3,890.45	$8,709.64
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $436.52 / $891.25	Professional		$204.17	$436.52	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $3,890.45 / $8,709.64	Facility		$933.25	$3,890.45	$8,709.64
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $426.58 / $831.76	Professional		$208.93	$426.58	$831.76
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $354.81 / $436.52	Facility		$263.03	$354.81	$436.52