Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.03 / $114.38 / $318.60	Facility		$52.03	$114.38	$318.60
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $167.69 / $269.83 / $536.51	Facility	25	$167.69	$269.83	$536.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.48 / $73.89 / $157.15	Professional		$45.48	$73.89	$157.15
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $48.92 / $93.50 / $199.78	Professional	25	$48.92	$93.50	$199.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.93 / $91.91 / $130.66	Professional		$68.93	$91.91	$130.66
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $86.34 / $103.63 / $126.15	Professional	25	$86.34	$103.63	$126.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.16 / $420.21 / $757.77	Facility		$164.16	$420.21	$757.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.48 / $92.05 / $146.19	Professional		$67.48	$92.05	$146.19
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 $68.62 / $116.46 / $198.06	Professional		$68.62	$116.46	$198.06
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $76.59 / $144.91 / $269.70	Professional		$76.59	$144.91	$269.70
Optum Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $112.37 / $144.13	Professional		$64.05	$112.37	$144.13
United Facility/Professional Professional Modifier Low / Median / High Price $69.89 / $108.81 / $194.72	Professional		$69.89	$108.81	$194.72
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $40.49 / $54.05 / $81.77	Professional		$40.49	$54.05	$81.77