Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.18 / $3,691.00 / $7,629.00	Facility		$218.18	$3,691.00	$7,629.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.76 / $19.54 / $43.64	Facility	53	$16.76	$19.54	$43.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.17 / $100.06 / $289.08	Professional		$48.17	$100.06	$289.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.39 / $116.94 / $433.64	Professional	50	$17.39	$116.94	$433.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,734.00 / $5,786.00 / $7,714.00	Facility		$4,734.00	$5,786.00	$7,714.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.78 / $93.97 / $137.07	Professional		$52.78	$93.97	$137.07
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $79.17 / $140.94 / $205.61	Professional	50	$79.17	$140.94	$205.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.93 / $142.94 / $297.33	Professional		$82.93	$142.94	$297.33
ConnectiCare Facility/Professional Facility Modifier Low / Median / High Price $1,005.87 / $1,643.00 / $1,677.00	Facility		$1,005.87	$1,643.00	$1,677.00
ConnectiCare Facility/Professional Professional Modifier Low / Median / High Price $93.53 / $156.78 / $694.64	Professional		$93.53	$156.78	$694.64
Health New England Facility/Professional Professional Modifier Low / Median / High Price $108.80 / $127.20 / $281.05	Professional		$108.80	$127.20	$281.05
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.00 / $3,075.00 / $6,664.00	Facility		$1,380.00	$3,075.00	$6,664.00
United Facility/Professional Professional Modifier Low / Median / High Price $92.64 / $192.13 / $319.52	Professional		$92.64	$192.13	$319.52