Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $298.02 / $3,959.00 / $10,300.00	Facility		$298.02	$3,959.00	$10,300.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $206.75 / $223.52 / $245.63	Facility	54	$206.75	$223.52	$245.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.53 / $292.20 / $505.82	Professional		$248.53	$292.20	$505.82
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 $284.64 / $324.07 / $474.01	Professional		$284.64	$324.07	$474.01
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 $252.44 / $361.95 / $540.37	Professional		$252.44	$361.95	$540.37
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.44 / $326.08 / $527.60	Professional		$3.44	$326.08	$527.60
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 $2.34 / $293.11 / $521.91	Professional		$2.34	$293.11	$521.91
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 $260.00 / $338.00 / $539.33	Professional		$260.00	$338.00	$539.33