Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.23 / $172.59 / $377.67	Facility		$107.23	$172.59	$377.67
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $128.80 / $267.57 / $708.47	Facility	25	$128.80	$267.57	$708.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.35 / $147.12 / $281.39	Professional		$97.35	$147.12	$281.39
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $90.00 / $188.36 / $343.25	Professional	25	$90.00	$188.36	$343.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.41 / $195.37 / $421.29	Professional		$155.41	$195.37	$421.29
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $173.61 / $204.25 / $421.29	Professional	25	$173.61	$204.25	$421.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.16 / $1,174.41 / $2,943.75	Facility		$164.16	$1,174.41	$2,943.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.08 / $183.07 / $286.52	Professional		$147.08	$183.07	$286.52
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 $146.69 / $244.44 / $393.18	Professional		$146.69	$244.44	$393.18
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $166.68 / $302.66 / $565.21	Professional		$166.68	$302.66	$565.21
Optum Facility/Professional Professional Modifier Low / Median / High Price $152.22 / $237.23 / $320.29	Professional		$152.22	$237.23	$320.29
United Facility/Professional Professional Modifier Low / Median / High Price $150.50 / $211.47 / $390.88	Professional		$150.50	$211.47	$390.88
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $92.16 / $117.57 / $161.82	Professional		$92.16	$117.57	$161.82