Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.92 / $88.05 / $199.92	Facility		$49.92	$88.05	$199.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.80 / $69.06 / $119.16	Professional		$43.80	$69.06	$119.16
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $59.39 / $66.18 / $150.94	Professional	25	$59.39	$66.18	$150.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.31 / $92.19 / $168.20	Professional		$69.31	$92.19	$168.20
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $66.80 / $68.67 / $78.36	Professional	25	$66.80	$68.67	$78.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $145.74 / $164.16 / $243.64	Facility		$145.74	$164.16	$243.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.39 / $88.10 / $125.33	Professional		$59.39	$88.10	$125.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $175.00 / $200.00	Facility		$150.00	$175.00	$200.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.46 / $92.12 / $164.32	Professional		$55.46	$92.12	$164.32
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $54.43 / $107.51 / $211.83	Professional		$54.43	$107.51	$211.83
Optum Facility/Professional Professional Modifier Low / Median / High Price $78.94 / $177.43 / $212.44	Professional		$78.94	$177.43	$212.44
United Facility/Professional Professional Modifier Low / Median / High Price $78.59 / $110.43 / $202.91	Professional		$78.59	$110.43	$202.91
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $42.04 / $58.14 / $83.08	Professional		$42.04	$58.14	$83.08