Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.40 / $1,639.00 / $4,396.00	Facility		$197.40	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $197.40 / $707.09 / $707.09	Facility	50	$197.40	$707.09	$707.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.61 / $78.98 / $357.00	Professional		$51.61	$78.98	$357.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $122.29 / $468.00 / $570.00	Professional	50	$122.29	$468.00	$570.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $92.07 / $151.31	Professional		$76.06	$92.07	$151.31
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $261.68 / $261.68 / $261.68	Professional	50	$261.68	$261.68	$261.68
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 $65.22 / $84.87 / $116.82	Professional		$65.22	$84.87	$116.82
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $81.91 / $112.35 / $163.15	Professional	50	$81.91	$112.35	$163.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.65 / $47.65 / $47.65	Facility		$47.65	$47.65	$47.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.37 / $86.02 / $134.22	Professional		$58.37	$86.02	$134.22
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.53 / $68.39 / $127.95	Professional		$0.53	$68.39	$127.95
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $326.24 / $326.24 / $326.24	Facility		$326.24	$326.24	$326.24
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.36 / $72.75 / $130.91	Professional		$0.36	$72.75	$130.91
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 $69.02 / $91.15 / $141.75	Professional		$69.02	$91.15	$141.75