Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $767.87 / $2,525.38 / $7,499.65	Facility		$767.87	$2,525.38	$7,499.65
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $505.08 / $505.08 / $505.08	Facility	53	$505.08	$505.08	$505.08
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,894.04 / $1,894.04 / $1,894.04	Facility	54	$1,894.04	$1,894.04	$1,894.04
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $378.81 / $378.81 / $378.81	Facility	55	$378.81	$378.81	$378.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $621.09 / $708.23 / $1,313.11	Professional		$621.09	$708.23	$1,313.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $320.27 / $354.12 / $656.56	Professional	52	$320.27	$354.12	$656.56
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $480.42 / $531.16 / $984.83	Professional	54	$480.42	$531.16	$984.83
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $96.08 / $106.23 / $196.97	Professional	55	$96.08	$106.23	$196.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,187.28 / $1,187.28 / $1,187.28	Professional		$1,187.28	$1,187.28	$1,187.28
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 $521.75 / $820.70 / $1,415.45	Professional		$521.75	$820.70	$1,415.45
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $782.62 / $1,231.06 / $1,873.62	Professional	50	$782.62	$1,231.06	$1,873.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $687.68 / $948.99 / $1,465.88	Professional		$687.68	$948.99	$1,465.88
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $657.02 / $1,072.94 / $2,125.10	Professional		$657.02	$1,072.94	$2,125.10
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 $739.38 / $947.78 / $1,601.47	Professional		$739.38	$947.78	$1,601.47
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $470.10 / $588.04 / $809.42	Professional		$470.10	$588.04	$809.42