Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $3,515.94 / $9,859.00	Facility		$100.00	$3,515.94	$9,859.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $2,636.96 / $2,636.96 / $2,636.96	Facility	54	$2,636.96	$2,636.96	$2,636.96
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $527.39 / $527.39 / $527.39	Facility	55	$527.39	$527.39	$527.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $792.80 / $979.13 / $1,801.24	Professional		$792.80	$979.13	$1,801.24
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $594.60 / $734.35 / $1,350.93	Professional	54	$594.60	$734.35	$1,350.93
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $118.92 / $146.87 / $270.19	Professional	55	$118.92	$146.87	$270.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,449.90 / $1,611.00 / $3,700.00	Facility		$1,449.90	$1,611.00	$3,700.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $714.53 / $1,123.96 / $1,938.48	Professional		$714.53	$1,123.96	$1,938.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $941.30 / $1,298.67 / $2,040.84	Professional		$941.30	$1,298.67	$2,040.84
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $899.79 / $1,469.41 / $2,910.33	Professional		$899.79	$1,469.41	$2,910.33
United Facility/Professional Facility Modifier Low / Median / High Price $9,565.00 / $9,565.00 / $9,565.00	Facility		$9,565.00	$9,565.00	$9,565.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,014.14 / $1,248.18 / $2,190.28	Professional		$1,014.14	$1,248.18	$2,190.28
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $644.45 / $806.14 / $1,102.19	Professional		$644.45	$806.14	$1,102.19