Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.92 / $158.24 / $444.44	Facility		$126.92	$158.24	$444.44
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $133.66 / $133.66 / $178.25	Facility	25	$133.66	$133.66	$178.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.35 / $161.88 / $326.02	Professional		$112.35	$161.88	$326.02
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $112.35 / $182.34 / $469.54	Professional	25	$112.35	$182.34	$469.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $157.72 / $187.26 / $391.36	Professional		$157.72	$187.26	$391.36
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $164.99 / $200.45 / $391.36	Professional	25	$164.99	$200.45	$391.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.16 / $708.04 / $1,668.45	Facility		$164.16	$708.04	$1,668.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.86 / $201.34 / $317.81	Professional		$147.86	$201.34	$317.81
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 $148.84 / $235.28 / $388.18	Professional		$148.84	$235.28	$388.18
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $155.02 / $281.49 / $525.67	Professional		$155.02	$281.49	$525.67
Optum Facility/Professional Professional Modifier Low / Median / High Price $176.23 / $280.80 / $413.12	Professional		$176.23	$280.80	$413.12
United Facility/Professional Professional Modifier Low / Median / High Price $167.09 / $230.09 / $425.90	Professional		$167.09	$230.09	$425.90
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $104.46 / $135.07 / $188.38	Professional		$104.46	$135.07	$188.38