Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $1,230.27 / $4,073.80	Facility		$208.93	$1,230.27	$4,073.80
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $60.26 / $83.18 / $158.49	Facility	53	$60.26	$83.18	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $316.23 / $741.31	Professional		$169.82	$316.23	$741.31
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $60.26 / $123.03 / $199.53	Professional	53	$60.26	$123.03	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $204.17 / $302.00	Professional		$173.78	$204.17	$302.00
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $87.10 / $87.10 / $87.10	Professional	53	$87.10	$87.10	$87.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,412.54 / $2,630.27	Facility		$1,288.25	$1,412.54	$2,630.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $380.19 / $645.65	Professional		$165.96	$380.19	$645.65
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $81.28 / $190.55 / $331.13	Professional	53	$81.28	$190.55	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility		$1,819.70	$1,819.70	$1,819.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $204.17 / $204.17 / $204.17	Professional	53	$204.17	$204.17	$204.17
Harvard Pilgrim Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $3,630.78 / $7,943.28	Facility		$691.83	$3,630.78	$7,943.28
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $426.58 / $870.96	Professional		$204.17	$426.58	$870.96
United Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $3,630.78 / $7,943.28	Facility		$691.83	$3,630.78	$7,943.28
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $416.87 / $831.76	Professional		$208.93	$416.87	$831.76
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $562.34 / $691.83	Facility		$416.87	$562.34	$691.83