Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $750.00 / $1,639.00 / $4,396.00	Facility		$750.00	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $235.17 / $245.57 / $269.85	Facility	54	$235.17	$245.57	$269.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.12 / $322.81 / $1,471.00	Professional		$240.12	$322.81	$1,471.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $232.22 / $248.52 / $1,264.75	Professional	54	$232.22	$248.52	$1,264.75
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 $285.72 / $329.18 / $540.54	Professional		$285.72	$329.18	$540.54
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $441.79 / $493.77 / $668.18	Professional	50	$441.79	$493.77	$668.18
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 $261.32 / $388.62 / $585.77	Professional		$261.32	$388.62	$585.77
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.91 / $356.15 / $593.58	Professional		$2.91	$356.15	$593.58
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 $1.98 / $339.19 / $573.99	Professional		$1.98	$339.19	$573.99
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 $265.80 / $351.87 / $599.13	Professional		$265.80	$351.87	$599.13