Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $254.94 / $1,706.00 / $4,473.00	Facility		$254.94	$1,706.00	$4,473.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $171.40 / $173.99 / $191.21	Facility	54	$171.40	$173.99	$191.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.33 / $231.99 / $901.00	Professional		$215.33	$231.99	$901.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,529.00 / $3,433.00 / $4,098.00	Facility		$1,529.00	$3,433.00	$4,098.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.69 / $266.05 / $392.51	Professional		$239.69	$266.05	$392.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.65 / $135.65 / $135.65	Facility		$135.65	$135.65	$135.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.25 / $280.43 / $426.92	Professional		$187.25	$280.43	$426.92
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.50 / $257.38 / $432.94	Professional		$1.50	$257.38	$432.94
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $265.11 / $265.11 / $265.11	Facility		$265.11	$265.11	$265.11
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.02 / $241.42 / $411.02	Professional		$1.02	$241.42	$411.02
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 $192.15 / $249.80 / $420.22	Professional		$192.15	$249.80	$420.22