Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $134.90 / $288.40	Facility		$69.18	$134.90	$288.40
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $275.42 / $275.42 / $275.42	Facility	25	$275.42	$275.42	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $104.71 / $239.88	Professional		$64.57	$104.71	$239.88
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $69.18 / $123.03 / $269.15	Professional	25	$69.18	$123.03	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $144.54	Professional		$79.43	$107.15	$144.54
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $87.10 / $109.65 / $151.36	Professional	25	$87.10	$109.65	$151.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $602.56 / $602.56	Facility		$173.78	$602.56	$602.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $208.93	Professional		$97.72	$151.36	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $173.78 / $199.53	Facility		$151.36	$173.78	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $138.04 / $234.42	Professional		$89.13	$138.04	$234.42
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $269.15	Professional		$87.10	$151.36	$269.15
Optum Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $194.98 / $269.15	Professional		$112.20	$194.98	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $93.33	Facility		$69.18	$69.18	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $251.19	Professional		$85.11	$141.25	$251.19
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $114.82 / $141.25	Facility		$85.11	$114.82	$141.25