Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.76 / $1,706.00 / $4,473.00	Facility		$212.76	$1,706.00	$4,473.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $136.71 / $145.22 / $159.57	Facility	54	$136.71	$145.22	$159.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.97 / $193.62 / $857.00	Professional		$163.97	$193.62	$857.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $135.97 / $145.47 / $740.87	Professional	54	$135.97	$145.47	$740.87
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 $188.43 / $214.53 / $313.79	Professional		$188.43	$214.53	$313.79
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 $164.15 / $234.04 / $351.06	Professional		$164.15	$234.04	$351.06
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.50 / $223.19 / $357.45	Professional		$1.50	$223.19	$357.45
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 / $206.55 / $350.45	Professional		$1.02	$206.55	$350.45
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 $154.71 / $217.77 / $331.87	Professional		$154.71	$217.77	$331.87