Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.75 / $1,639.00 / $4,473.00	Facility		$160.75	$1,639.00	$4,473.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.65 / $160.84 / $275.63	Professional		$122.65	$160.84	$275.63
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $799.01 / $799.01 / $799.01	Professional	22	$799.01	$799.01	$799.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.44 / $164.15 / $225.30	Professional		$146.44	$164.15	$225.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,779.00 / $3,647.00 / $4,098.00	Facility		$2,779.00	$3,647.00	$4,098.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.50 / $150.83 / $226.45	Professional		$114.50	$150.83	$226.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.09 / $118.09 / $118.09	Facility		$118.09	$118.09	$118.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.98 / $159.88 / $265.33	Professional		$104.98	$159.88	$265.33
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $81.81 / $144.49 / $245.47	Professional		$81.81	$144.49	$245.47
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 $81.81 / $122.72 / $178.23	Professional		$81.81	$122.72	$178.23
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 $146.88 / $167.77 / $282.24	Professional		$146.88	$167.77	$282.24