Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $296.33 / $1,639.00 / $4,396.00	Facility		$296.33	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $729.75 / $729.75 / $1,681.20	Facility	50	$729.75	$729.75	$1,681.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $60.70 / $275.00	Professional		$35.72	$60.70	$275.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.51 / $171.18 / $411.00	Professional	50	$77.51	$171.18	$411.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.32 / $50.32 / $50.32	Professional		$50.32	$50.32	$50.32
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $75.48 / $75.48 / $75.48	Professional	50	$75.48	$75.48	$75.48
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 $43.94 / $62.05 / $81.22	Professional		$43.94	$62.05	$81.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $53.80 / $77.01 / $120.07	Professional	50	$53.80	$77.01	$120.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.29 / $30.29 / $30.29	Facility		$30.29	$30.29	$30.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.93 / $62.29 / $92.00	Professional		$38.93	$62.29	$92.00
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.44 / $51.03 / $88.73	Professional		$0.44	$51.03	$88.73
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 $0.30 / $47.45 / $85.05	Professional		$0.30	$47.45	$85.05
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 $49.17 / $66.31 / $98.74	Professional		$49.17	$66.31	$98.74