Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.76 / $1,639.00 / $4,396.00	Facility		$426.76	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $126.18 / $131.91 / $153.88	Facility	54	$126.18	$131.91	$153.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.69 / $168.24 / $361.16	Professional		$143.69	$168.24	$361.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $210.94 / $210.94 / $210.94	Professional		$210.94	$210.94	$210.94
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 $130.71 / $179.56 / $314.73	Professional		$130.71	$179.56	$314.73
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $258.66 / $258.66 / $760.89	Professional	50	$258.66	$258.66	$760.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.58 / $125.58 / $125.58	Facility		$125.58	$125.58	$125.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.19 / $208.87 / $344.13	Professional		$144.19	$208.87	$344.13
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $135.65 / $207.42 / $329.78	Professional		$135.65	$207.42	$329.78
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $441.55 / $441.55 / $441.55	Facility		$441.55	$441.55	$441.55
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $171.59 / $203.48 / $257.39	Professional		$171.59	$203.48	$257.39
United Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $1,427.00 / $1,998.00	Facility		$200.00	$1,427.00	$1,998.00
United Facility/Professional Professional Modifier Low / Median / High Price $164.49 / $214.92 / $376.10	Professional		$164.49	$214.92	$376.10