Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $125.89 / $288.40	Facility		$50.12	$125.89	$288.40
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $50.12 / $251.19 / $363.08	Facility	25	$50.12	$251.19	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $107.15 / $269.15	Professional		$57.54	$107.15	$269.15
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $60.26 / $120.23 / $295.12	Professional	25	$60.26	$120.23	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $154.88	Professional		$85.11	$117.49	$154.88
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $97.72 / $125.89 / $165.96	Professional	25	$97.72	$125.89	$165.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $1,000.00 / $1,000.00	Facility		$173.78	$1,000.00	$1,000.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $213.80	Professional		$107.15	$165.96	$213.80
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 $87.10 / $147.91 / $263.03	Professional		$87.10	$147.91	$263.03
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $177.83 / $309.03	Professional		$102.33	$177.83	$309.03
Optum Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $223.87	Professional		$109.65	$177.83	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $147.91 / $269.15	Professional		$85.11	$147.91	$269.15
Well Sense Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $131.83 / $162.18	Facility		$95.50	$131.83	$162.18