Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.00 / $328.82 / $928.80	Facility		$139.00	$328.82	$928.80
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $638.48 / $638.48 / $1,381.16	Facility	25	$638.48	$638.48	$1,381.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.15 / $112.01 / $220.78	Professional		$92.15	$112.01	$220.78
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $251.98 / $342.58 / $503.95	Professional	25	$251.98	$342.58	$503.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.26 / $216.22 / $338.48	Professional		$113.26	$216.22	$338.48
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $118.40 / $144.13 / $427.67	Professional	25	$118.40	$144.13	$427.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,135.39 / $5,706.00 / $10,362.00	Facility		$5,135.39	$5,706.00	$10,362.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.38 / $158.46 / $227.63	Professional		$114.38	$158.46	$227.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11,921.00 / $11,975.00 / $15,343.00	Facility		$11,921.00	$11,975.00	$15,343.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.83 / $186.32 / $286.05	Professional		$120.83	$186.32	$286.05
Harvard Pilgrim Facility/Professional Professional Modifier Low / Median / High Price $122.72 / $194.13 / $371.10	Professional		$122.72	$194.13	$371.10
United Facility/Professional Professional Modifier Low / Median / High Price $127.39 / $197.45 / $359.66	Professional		$127.39	$197.45	$359.66
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $90.00 / $255.60	Professional	25	$80.00	$90.00	$255.60
Well Sense Facility/Professional Professional Modifier Low / Median / High Price $87.02 / $108.88 / $147.60	Professional		$87.02	$108.88	$147.60