Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $286.43 / $1,639.00 / $4,396.00	Facility		$286.43	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $671.73 / $671.73 / $671.73	Facility	50	$671.73	$671.73	$671.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.21 / $69.14 / $364.42	Professional		$37.21	$69.14	$364.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $25.00 / $105.50 / $391.50	Professional	50	$25.00	$105.50	$391.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.65 / $53.30 / $106.03	Professional		$26.65	$53.30	$106.03
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $119.92 / $119.92 / $119.92	Professional	50	$119.92	$119.92	$119.92
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 $47.83 / $65.38 / $81.65	Professional		$47.83	$65.38	$81.65
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $56.79 / $76.54 / $122.47	Professional	50	$56.79	$76.54	$122.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.63 / $30.63 / $30.63	Facility		$30.63	$30.63	$30.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.14 / $63.77 / $99.29	Professional		$41.14	$63.77	$99.29
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.35 / $46.85 / $91.78	Professional		$0.35	$46.85	$91.78
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 $0.24 / $49.35 / $89.99	Professional		$0.24	$49.35	$89.99
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 $50.15 / $69.50 / $104.79	Professional		$50.15	$69.50	$104.79