Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $512.00 / $3,691.00 / $7,629.00	Facility		$512.00	$3,691.00	$7,629.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,514.64 / $3,863.00 / $5,300.00	Facility	50	$2,514.64	$3,863.00	$5,300.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $36.33 / $42.09 / $97.65	Facility	53	$36.33	$42.09	$97.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.54 / $228.26 / $645.58	Professional		$95.54	$228.26	$645.58
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.52 / $141.52 / $191.19	Professional	22	$141.52	$141.52	$191.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $139.13 / $405.48 / $2,185.21	Professional	50	$139.13	$405.48	$2,185.21
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $20.80 / $44.34 / $71.39	Professional	53	$20.80	$44.34	$71.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,410.00 / $6,763.00 / $10,432.00	Facility		$5,410.00	$6,763.00	$10,432.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.71 / $204.44 / $290.94	Professional		$110.71	$204.44	$290.94
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $166.36 / $302.74 / $436.42	Professional	50	$166.36	$302.74	$436.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $1,309.52 / $1,309.52	Facility		$550.00	$1,309.52	$1,309.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.18 / $287.39 / $661.30	Professional		$167.18	$287.39	$661.30
ConnectiCare Facility/Professional Facility Modifier Low / Median / High Price $1,340.80 / $1,643.00 / $1,677.00	Facility		$1,340.80	$1,643.00	$1,677.00
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $284.14 / $731.56 / $1,064.41	Professional		$284.14	$731.56	$1,064.41
Health New England Facility/Professional Facility Modifier Low / Median / High Price $741.00 / $2,198.69 / $2,689.70	Facility		$741.00	$2,198.69	$2,689.70
Health New England Facility/Professional Professional Modifier Low / Median / High Price $192.47 / $355.80 / $680.13	Professional		$192.47	$355.80	$680.13
United Facility/Professional Facility Modifier Low / Median / High Price $1,157.00 / $4,210.00 / $7,760.00	Facility		$1,157.00	$4,210.00	$7,760.00
United Facility/Professional Professional Modifier Low / Median / High Price $211.56 / $419.99 / $728.94	Professional		$211.56	$419.99	$728.94