Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,214.63 / $1,494.60 / $4,760.39	Facility		$1,214.63	$1,494.60	$4,760.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $1,214.63	Professional		$1,214.63	$1,214.63	$1,214.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,452.09 / $1,821.95 / $4,999.17	Facility		$1,452.09	$1,821.95	$4,999.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,238.92 / $1,238.92	Professional		$1,214.63	$1,238.92	$1,238.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Facility		$1,238.93	$1,238.93	$1,238.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $1,299.89 / $2,012.02 / $3,823.96	Professional		$1,299.89	$2,012.02	$3,823.96
United Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $1,214.63	Professional		$1,214.63	$1,214.63	$1,214.63
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $1,070.23 / $1,284.28 / $2,027.02	Professional		$1,070.23	$1,284.28	$2,027.02