Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.81 / $1,706.00 / $4,473.00	Facility		$257.81	$1,706.00	$4,473.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $170.99 / $175.95 / $193.36	Facility	54	$170.99	$175.95	$193.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.02 / $231.89 / $432.52	Professional		$200.02	$231.89	$432.52
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 $238.49 / $275.94 / $403.60	Professional		$238.49	$275.94	$403.60
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 $197.14 / $284.55 / $425.92	Professional		$197.14	$284.55	$425.92
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.41 / $261.27 / $422.72	Professional		$1.41	$261.27	$422.72
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 $0.96 / $247.89 / $395.64	Professional		$0.96	$247.89	$395.64
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 $184.31 / $260.82 / $385.17	Professional		$184.31	$260.82	$385.17