Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,825.00 / $3,825.00 / $4,590.00	Facility		$3,825.00	$3,825.00	$4,590.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,825.00 / $3,825.00 / $4,482.00	Professional		$3,825.00	$3,825.00	$4,482.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,483.13 / $7,048.78 / $18,809.46	Facility		$4,483.13	$7,048.78	$18,809.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,750.00 / $3,825.00 / $3,825.00	Professional		$3,750.00	$3,825.00	$3,825.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,825.00 / $3,825.00 / $3,825.00	Facility		$3,825.00	$3,825.00	$3,825.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,825.00 / $3,825.00 / $3,825.00	Professional		$3,825.00	$3,825.00	$3,825.00
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $3,825.00 / $5,551.60 / $11,805.86	Professional		$3,825.00	$5,551.60	$11,805.86
United Facility/Professional Professional Modifier Low / Median / High Price $3,750.00 / $3,750.00 / $3,825.00	Professional		$3,750.00	$3,750.00	$3,825.00
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $3,825.00 / $4,207.50 / $5,355.00	Professional		$3,825.00	$4,207.50	$5,355.00