Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.59 / $1,639.00 / $4,396.00	Facility		$103.59	$1,639.00	$4,396.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.67 / $105.95 / $310.02	Professional		$58.67	$105.95	$310.02
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.18 / $51.80 / $126.89	Professional	52	$30.18	$51.80	$126.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.80 / $111.87 / $131.62	Professional		$99.80	$111.87	$131.62
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 $59.69 / $94.65 / $152.62	Professional		$59.69	$94.65	$152.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $115.92 / $135.54 / $282.31	Professional	50	$115.92	$135.54	$282.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.33 / $93.19 / $163.09	Professional		$58.33	$93.19	$163.09
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $55.59 / $99.53 / $171.41	Professional		$55.59	$99.53	$171.41
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $219.60 / $219.60 / $219.60	Facility		$219.60	$219.60	$219.60
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.48 / $67.30 / $109.68	Professional		$0.48	$67.30	$109.68
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 $82.42 / $110.95 / $199.70	Professional		$82.42	$110.95	$199.70