Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $1,000.00 / $5,888.44	Facility		$204.17	$1,000.00	$5,888.44
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,265.80 / $5,888.44 / $7,413.10	Facility	50	$4,265.80	$5,888.44	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $239.88 / $602.56	Professional		$109.65	$239.88	$602.56
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $316.23 / $436.52 / $501.19	Professional	50	$316.23	$436.52	$501.19
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $36.31 / $36.31 / $37.15	Professional	53	$36.31	$36.31	$37.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $151.36	Professional		$93.33	$125.89	$151.36
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $162.18 / $239.88 / $977.24	Professional	50	$162.18	$239.88	$977.24
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 $100.00 / $218.78 / $309.03	Professional		$100.00	$218.78	$309.03
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $323.59 / $457.09	Professional	50	$147.91	$323.59	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Facility		$1,348.96	$1,348.96	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $295.12 / $616.60	Professional		$138.04	$295.12	$616.60
Harvard Pilgrim Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $7,943.28 / $7,943.28	Facility		$7,943.28	$7,943.28	$7,943.28
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $302.00 / $616.60	Professional		$123.03	$302.00	$616.60
United Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $7,943.28 / $7,943.28	Facility		$7,943.28	$7,943.28	$7,943.28
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $275.42 / $602.56	Professional		$123.03	$275.42	$602.56
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $309.03	Facility		$190.55	$190.55	$309.03
Well Sense Facility/Professional Facility Modifier 50 Low / Median / High Price $288.40 / $288.40 / $288.40	Facility	50	$288.40	$288.40	$288.40