Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $532.02 / $1,639.00 / $4,396.00	Facility		$532.02	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $351.11 / $351.11 / $351.11	Facility	50	$351.11	$351.11	$351.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.86 / $99.79 / $406.00	Professional		$55.86	$99.79	$406.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $126.15 / $242.29 / $648.00	Professional	50	$126.15	$242.29	$648.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.81 / $109.93 / $109.93	Professional		$90.81	$109.93	$109.93
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $136.21 / $136.21 / $312.44	Professional	50	$136.21	$136.21	$312.44
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 $68.88 / $102.58 / $133.81	Professional		$68.88	$102.58	$133.81
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $87.37 / $149.69 / $196.22	Professional	50	$87.37	$149.69	$196.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.54 / $58.54 / $58.54	Facility		$58.54	$58.54	$58.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.07 / $96.23 / $155.97	Professional		$62.07	$96.23	$155.97
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $76.98 / $153.97	Professional		$0.80	$76.98	$153.97
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 $0.60 / $74.00 / $155.24	Professional		$0.60	$74.00	$155.24
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 $85.02 / $119.16 / $168.84	Professional		$85.02	$119.16	$168.84