Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $3,904.58 / $9,859.00	Facility		$100.00	$3,904.58	$9,859.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $2,928.44 / $2,928.44 / $2,928.44	Facility	54	$2,928.44	$2,928.44	$2,928.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,076.34 / $1,158.88 / $2,853.78	Professional		$1,076.34	$1,158.88	$2,853.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,769.10 / $5,299.00 / $8,600.00	Facility		$4,769.10	$5,299.00	$8,600.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,133.74 / $1,783.37 / $3,075.75	Professional		$1,133.74	$1,783.37	$3,075.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,438.87 / $2,059.51 / $2,728.30	Professional		$1,438.87	$2,059.51	$2,728.30
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $1,427.69 / $2,331.50 / $4,617.80	Professional		$1,427.69	$2,331.50	$4,617.80
United Facility/Professional Facility Modifier Low / Median / High Price $11,155.00 / $11,155.00 / $11,155.00	Facility		$11,155.00	$11,155.00	$11,155.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,406.29 / $1,782.60 / $3,643.68	Professional		$1,406.29	$1,782.60	$3,643.68
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $922.23 / $1,106.68 / $1,626.81	Professional		$922.23	$1,106.68	$1,626.81