Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.16 / $115.95 / $291.68	Facility		$51.16	$115.95	$291.68
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $49.92 / $248.99 / $359.47	Facility	25	$49.92	$248.99	$359.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.89 / $109.51 / $250.18	Professional		$68.89	$109.51	$250.18
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $72.48 / $130.13 / $278.74	Professional	25	$72.48	$130.13	$278.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $94.50 / $94.50	Professional	50	$94.50	$94.50	$94.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.57 / $131.44 / $183.67	Professional		$103.57	$131.44	$183.67
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $94.22 / $145.66 / $300.45	Professional	25	$94.22	$145.66	$300.45
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 $98.97 / $130.27 / $215.21	Professional		$98.97	$130.27	$215.21
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 $104.76 / $170.59 / $279.16	Professional		$104.76	$170.59	$279.16
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $112.76 / $208.22 / $382.08	Professional		$112.76	$208.22	$382.08
Optum Facility/Professional Professional Modifier Low / Median / High Price $98.17 / $164.90 / $225.39	Professional		$98.17	$164.90	$225.39
United Facility/Professional Professional Modifier Low / Median / High Price $104.46 / $164.62 / $316.86	Professional		$104.46	$164.62	$316.86
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $83.18 / $118.31	Professional		$63.75	$83.18	$118.31