Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $649.48 / $1,639.00 / $4,004.10	Facility		$649.48	$1,639.00	$4,004.10
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $34.06 / $35.61 / $66.50	Facility	52	$34.06	$35.61	$66.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.04 / $127.20 / $554.00	Professional		$66.04	$127.20	$554.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.26 / $128.26 / $211.63	Professional		$128.26	$128.26	$211.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,529.00 / $3,433.00 / $4,098.00	Facility		$1,529.00	$3,433.00	$4,098.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.08 / $125.11 / $207.14	Professional		$71.08	$125.11	$207.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $397.29 / $397.29 / $397.29	Facility		$397.29	$397.29	$397.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.84 / $114.56 / $197.30	Professional		$62.84	$114.56	$197.30
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $56.65 / $131.40 / $405.72	Professional		$56.65	$131.40	$405.72
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $405.72 / $777.59 / $777.59	Facility		$405.72	$777.59	$777.59
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $61.52 / $69.38 / $197.10	Professional		$61.52	$69.38	$197.10
United Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $1,925.00 / $4,715.00	Facility		$408.00	$1,925.00	$4,715.00
United Facility/Professional Professional Modifier Low / Median / High Price $128.44 / $168.01 / $243.23	Professional		$128.44	$168.01	$243.23